Potential of γ-Glutamyl Transferase as a Novel Risk Factor for Cardiovascular Disease

Article information

Endocrinol Metab. 2023;38(6):667-668

Publication date (electronic) : 2023 December 22

doi : https://doi.org/10.3803/EnM.2023.602

¹Department of Endocrinology and Metabolism, College of Medicine, Kyung Hee University, Seoul, Korea

²Center for Digital Health, Kyung Hee University, Seoul, Korea

Corresponding author: Sang Youl Rhee. Department of Endocrinology and Metabolism, College of Medicine, Kyung Hee University, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea Tel: +82-2-958-8200, Fax: +82-2-968-1848, E-mail: rheesy@khu.ac.kr

Received 2023 November 8; Accepted 2023 November 13.

In the latest edition of Endocrinology and Metabolism, we are thrilled to present an outstanding research article by Jae-Seung Yun and his distinguished colleagues. The article, titled “Long-term cumulative exposure to high γ-glutamyl transferase levels and the risk of cardiovascular disease: a nationwide population-based cohort study,” offers a comprehensive exploration of the potential link between prolonged exposure to high γ-glutamyl transferase (GGT) levels and the occurrence of cardiovascular disease (CVD) [1]. The research team, composed of members from several esteemed institutions, utilized a nationwide cohort study to delve into the intricate relationship between GGT levels and cardiovascular health. Their meticulous methodologies and thorough analysis provide deep insights into the factors influencing cardiovascular risk.

The study cohort was divided based on exposure to high GGT levels over a 4-year period. Of the 1,640,127 subjects, 61.7% (1,012,181 individuals) had not been exposed to high GGT levels, while 13.6% (222,835 individuals) had consistently high GGT exposure throughout the 4 years. It was noted that subjects with more frequent exposures to high GGT levels had higher rates of obesity, smoking, and alcohol consumption, along with decreased physical activity. This subgroup also included a larger proportion of individuals in the lower-income bracket, showed higher fatty liver index (FLI) values, and displayed traditional cardiovascular risk factors such as hypertension (HTN), diabetes mellitus, and dyslipidemia.

During a median follow-up period of 6.4 years, the study found that persistent high GGT exposure was associated with an increased risk of CVD. This risk increased in a dose-response manner, correlating with the cumulative increase in GGT quartiles over the observation period. Notably, a stronger association was observed between overall GGT levels and the onset of myocardial infarction (MI), stroke, and mortality. Individuals who did not have HTN or dyslipidemia showed a significant correlation between GGT levels and the incidence of MI, stroke, and death. Similarly, those with a body mass index below 25 kg/m2 and an FLI under 30 showed a significant association between continuous GGT exposure and an increased risk of CVD or death.

CVD continues to be a major health concern globally, with a multitude of factors contributing to its onset [2-4]. This study provides a significant contribution by identifying a potential risk factor, thus providing clinicians, researchers, and the wider health community with new insights for preventative strategies and patient care. I am confident that this publication will serve as a crucial reference for future research into the effects of GGT on cardiovascular health.

Notes

CONFLICTS OF INTEREST

No potential conflict of interest relevant to this article was reported.

References

1. Baek HS, Kim B, Lee SH, Lim DJ, Kwon HS, Chang SA, et al. Long-term cumulative exposure to high γ-glutamyl transferase levels and the risk of cardiovascular disease: a nationwide population-based cohort study. Endocrinol Metab (Seoul) 2023;38:770–81.

2. Lee HH, Cho SMJ, Lee H, Baek J, Bae JH, Chung WJ, et al. Korea heart disease fact sheet 2020: analysis of nationwide data. Korean Circ J 2021;51:495–503.

3. Park JY, Han K, Kim HS, Cho JH, Yoon KH, Kim MK, et al. Cumulative exposure to high γ-glutamyl transferase level and risk of diabetes: a nationwide population-based study. Endocrinol Metab (Seoul) 2022;37:272–80.

4. Oh J, Kim S, Lee M, Rhee SY, Kim MS, Shin JY, et al. National and regional trends in the prevalence of type 2 diabetes and associated risk factors among Korean adults, 2009-2021. Sci Rep 2023;13:16727.

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