title: Elevated Serum Gamma-glutamyl Transpeptidase Levels and Fatty Liver Strongly Predict the Presence of Carotid Plaque.
abstract: OBJECTIVE
  There is a strong relationship between carotid atherosclerosis and future cardiovascular disease (CVD). This study sought to clarify the association of fatty liver and an elevated serum gamma-glutamyl transpeptidase (GGT) level with carotid atherosclerosis.
  
  
  METHODS
  We reviewed the medical records of subjects who underwent medical checkups at our institute. Carotid atherosclerosis and fatty liver were assessed using ultrasound (US), and predictors of increased carotid intima-media thickness (IMT) and carotid plaque were identified using a logistic regression model.
  
  
  RESULTS
  In total, 958 subjects (564 men, 394 women; median age, 59 years) were enrolled. The median value of the mean carotid IMT was 0.713 mm, and the frequency of carotid plaque was 19.5%. For the highest quartile of the mean carotid IMT (≥ 0.863 mm), a male sex, older age, hypertension (HT), dyslipidemia (DL) and type 2 diabetes mellitus (DM) were identified as independent predictors. A male sex, older age, HT and elevated serum GGT level were found to be significant predictors of the presence of carotid plaque. In addition, fatty liver correlated with the existence of carotid plaque. When the combination of the serum GGT level and presence or absence of fatty liver was included as a variable in the analysis, a male sex, older age, HT and fatty liver with a serum GGT level of ≥ 83 IU/L (90th percentile) (odds ratio 3.21, 95% confidence interval 1.27-8.12, p=0.014)were identified to be significantly associated with carotid plaque.
  
  
  CONCLUSIONS
  This study suggests that the simultaneous presence of an elevated serum GGT level and fatty liver is highly predictive of carotid plaque.
authors.affiliation: Department of Hepatology, Kanazawa Medical University.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Toshikuni
authors.forename: Takayoshi
authors.initials: T
authors.lastname: Asaji
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Nakanishi
authors.forename: Shin-ya
authors.initials: SY
authors.lastname: Nagasawa
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Uenishi
authors.forename: Mikihiro
authors.initials: M
authors.lastname: Tsutsumi
mesh_terms: D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D059168:Carotid Intima-Media Thickness; D005234:Fatty Liver / Q000150:complications* / Q000201:enzymology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D058226:Plaque, Atherosclerotic / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D005723:gamma-Glutamyltransferase / Q000097:blood*
chemical_list: D005723:gamma-Glutamyltransferase