title: Serum γ-glutamyltranspeptidase predicts all-cause, cardiovascular and liver mortality in older adults.
abstract: BACKGROUND
  Serum γ-glutamyltranspeptidase (GGT), a marker of fatty liver disease (FLD), predicts mortality in young adults. However, the association between serum GGT and mortality in older adults is unclear.
  
  
  OBJECTIVE
  To examine if elevated serum GGT predicts all-cause, cardiovascular (CVD), and liver mortality in community-dwelling older adults.
  
  
  METHODS
  A prospective cohort study including 2364 participants (mean-age 70 yr, BMI-24.5 kg/m2, 54% women) from the Rancho Bernardo Study who attended a research visit in 1984-87 when multiple metabolic covariates were ascertained including serum GGT. They were followed for a mean (± standard deviation) of 13.7 (±6.2) years.
  
  
  METHODS
  Multivariable-adjusted Cox-proportional hazards analyses were conducted to examine the association between elevated serum GGT (>51 U/L in men and > 33 U/L in women) and all-cause, CVD, and liver mortality.
  
  
  RESULTS
  In these older men and women, cumulative mortality was 56.2% (n=1329) with CVD and liver mortality accounting for 49.4% and 2.3% of all deaths, respectively, over 32,387 person-years of follow-up. In multivariate analyses (adjusted for age, sex, alcohol use, body-mass-index, total cholesterol, HDL cholesterol, serum triglyceride, smoking status, systolic blood pressure, diabetes mellitus, serum interleukin-6, and c-reactive protein), serum GGT elevation was significantly associated with all-cause (HR, 1.55, 95% CI, 1.21-1.98), CVD (HR, 1.51, 95% CI, 1.04-2.17), and liver mortality (HR, 9.10, 95% CI, 3.42-24.26).
  
  
  CONCLUSIONS
  In community-dwelling older adults, serum GGT is an independent predictor of all-cause, CVD, and liver mortality.
authors.affiliation: Division of Gastroenterology, University of California, San Diego, La Jolla, CA 92093-0607 ; Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA 92093-0607.
authors.forename: Rohit
authors.initials: R
authors.lastname: Loomba
authors.forename: Iliana
authors.initials: I
authors.lastname: Doycheva
authors.forename: Ricki
authors.initials: R
authors.lastname: Bettencourt
authors.forename: Benjamin
authors.initials: B
authors.lastname: Cohen
authors.forename: Christina L
authors.initials: CL
authors.lastname: Wassel
authors.forename: David
authors.initials: D
authors.lastname: Brenner
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barrett-Connor
keywords: GGT; NAFLD; and death