DOI QR코드

DOI QR Code

Relations between Normal Serum Gamma-glutamyltransferase and Risk Factors of Coronary Heart Diseases according to Age and Gender

연령과 성별에 따른 정상 혈청 Gamma-glutamyltransferase와 관상동맥질환 위험인자와의 관계

  • Kwon, Se Young (Department of Biomedical Laboratory Science, Daegu Health College) ;
  • Na, Young Ak (Department of Biomedical Laboratory Science, Daegu Health College)
  • 권세영 (대구보건대학교 임상병리과) ;
  • 나영악 (대구보건대학교 임상병리과)
  • Received : 2016.01.29
  • Accepted : 2016.02.23
  • Published : 2016.03.31

Abstract

Serum gamma-glutamyltransferase (GGT) has been widely used as a marker of alcohol intake and liver failure. Recently, the relativity between GGT and various diseases has been identified with growing interest. In this study, we examined relativity between GGT value and risk factors of coronary heart diseases among those with normal GGT value, excluding heavy drinkers. Specifically, we compared the differences based on age and gender. Data from the 2011 KNHNES were used (N=3,619). When the subjects were categorized according to quartile based on the serum GGT levels, there was 10~20, 21~27, 28~38, 39~71 IU/L in men, and 6~12, 13~16, 17~22, 23~42 IU/L in women. The mean of most variables was the highest in the $4^{th}$ quartile (Q4), however age and LDL Cholesterol were the highest in the $2^{nd}$ quartile (Q2) in men. The FRS and 10-year CHD risk was the highest in the $2^{nd}$ quartile in men, and the highest in the $4^{th}$ quartile in women. Increased GGT was correspondingly linked with age in women but age was the highest in GGT in the $2^{nd}$ quartile in men. In the 70's, the highest Q1 and Q2 was in men and the highest Q3 and Q4 in women. Although GGT value was within the normal range, increased GGT showed correlation with various risk factors. The FRS and 10-year CHD risk showed different patterns according to age and gender along with increased GGT value.

혈중 gamma-glutamyltransferase (GGT)는 지금까지 간기능장애와 대표적인 알코올 섭취 관련 지표로서 폭넓게 사용되어 왔다. 현재 다양한 질환과의 관련성이 밝혀지면서 그 관심이 커지고 있다. 본 연구에서는 고도의 음주군에 해당하는 대상자를 제외하고 GGT 수치가 정상 범위에 속하는 대상자들에서 GGT 수치에 따른 관상동맥 질환 위험 요인과의 관련성을 살펴보고, 연령과 성별에 따른 특성을 비교 검토 하였다. 분석 자료는 2011 국민건강영양조사 데이터를 이용하였다(N=3,619). GGT(IU/L) 수준에 따라 사분위수(quartile) 네 군으로 나누었을 때 GGT기준은 남성의 경우 순서대로 10~20, 21~27, 28~38, 39~71 IU/L 이었고, 여성의 경우 각각 6~12, 13~16, 17~22, 23~42 IU/L 였다. 대부분의 변수에서 평균치는 GGT 4분위수로 갈수록 수치가 높게 나타났으나, 남성에서 연령과 저밀도콜레스테롤은 GGT 2분위수에서 수치가 가장 높았다. FRS와 10년 관상동맥 질환 위험도는 남성에서 GGT 2분위수에서 유의하게 높았고, 여성의 경우 GGT 4분위수에서 유의하게 높았다. 여성의 경우 GGT 수준이 높아질수록 연령이 증가하였으나, 남성의 경우 GGT 2분위수에서 가장 높았다. 연령 70대에서 남성의 경우 1,2분위수 분포가 가장 많고, 여성의 경우 3,4분위수 분포가 많아 그 차이가 뚜렷하게 나타났다. GGT 수치가 정상 범위에 속하더라도 GGT 수치가 증가함에 따라 여러 위험인자와 관련성이 있음을 증명하였다. 그러나 GGT 수치 증가와 함께 관상동맥질환 관련 수치와 10년 위험도 관련 예측치 증가에 대한 부분은 연령과 성별에 따라 서로 다른 양상을 보였다.

Keywords

References

  1. Conigrave KM, Saunders JB, Reznik RB, Whitfield JB. Prediction of alcohol-related harm by laboratory test results. Clin Chem. 1993;39:2266-2270.
  2. Whitfield JB. Gamma-glutamyl transferase. Crit Rev Clin Lab Sci. 2001;38:263-355. https://doi.org/10.1080/20014091084227
  3. Lee DH, Blomhoff R, Jacobs DR Jr. Is serum gamma-glutamyltransferase a marker of oxidative stress? Free Radic Res. 2004;38:535-539. https://doi.org/10.1080/10715760410001694026
  4. Neuschwander-Tetri BA, Caldwell SH. Nonalcoholic steatohepatitis: summary of an AASLD single topic conference. Hepatology. 2003;37:1202-1219. https://doi.org/10.1053/jhep.2003.50193
  5. Pompella A, Emdin M, Passino C, Paolicchi A. The significance of serum $\gamma$-glutamyltransferase in cardiovascular diseases. Clin Chem Lab Med. 2004;42:1085-1091.
  6. Paolicchi A, Emdin M, Ghliozeni E, Ciancia E, Passino C, Popoff G, Pompella A. Human atherosclerotic plaques contain gamma-glutamyl transpeptidase enzyme activity. Circulation. 2004;109:1440. https://doi.org/10.1161/01.CIR.0000120558.41356.E6
  7. Emdin M, Passino C, Michelassi C, Titta F, L'Abbate A, Donato L, Pompella A, Paolicchi A. Prognostic value of serum gamma-glutamyl transferase activity after myocardial infarction. Eur Heart J. 2001;22:1802-1807. https://doi.org/10.1053/euhj.2001.2807
  8. Lee DH, Jacobs DR Jr, Gross M, Kiefe CI, Roseman J, Lewis CE, et al. Gamma-glutamyltransferase is a predictor of incident diabetes and hypertension: the coronary artery risk development in young adults (CARDIA) Study. Clin Chem. 2003;49:1358-1366. https://doi.org/10.1373/49.8.1358
  9. Rantala AO, Lilja M, Kauma H, Savolainen MJ, Reunanen A, Kesaniemi YA. $\gamma$-Glutamyl transpeptidase and the metabolic syndrome. J Intern Med. 2000;248:230-238. https://doi.org/10.1046/j.1365-2796.2000.00723.x
  10. Ryu S, Chang Y, Kim DI, Kim WS, Suh BS. Gamma-glutamyltransferase as a predictor of chronic kidney disease in nonhypertensive and nondiabetic Korean men. Clin Chem. 2007;53:71-77.
  11. Whitfield JB. Serum $\gamma$-Glutamyltransferase and risk of disease. Clin Chem. 2007;53:1-2.
  12. Perry IJ, Wannamethee SG, Shaper AG: Prospective study of serum gamma-glutamyltransferase and risk of NIDDM. Diabetes Care.1998;21:732-737. https://doi.org/10.2337/diacare.21.5.732
  13. Kim KN, Kim KM, Lee DJ, Joo NS. Serum gamma-glutamyltransferase concentration correlates with framingham risk score in Koreans. J Korean Med Sci. 2011;26:1305-1309. https://doi.org/10.3346/jkms.2011.26.10.1305
  14. Chun HJ, Park SK, Ryoo JH. Association of serum $\gamma$-glutamyltransferase level and incident prehypertension in Korean men. J Korean Med Sci. 2013;28:1603-1608. https://doi.org/10.3346/jkms.2013.28.11.1603
  15. Wilson PWF, D' Agostino RB, Levy D, Belanger AM, Silbershatz H, Kannel WB. Prediction of coronary heart diseases using risk factor categories. Circulation. 1998;97:1837-1847. https://doi.org/10.1161/01.CIR.97.18.1837
  16. Park WH, Chae SC, Chun BY, Lee KE, Kim BW, Kim JG, et al. Relationship between serum gamma-glutamyltransferase and metabolic syndrome among Korean non-diabetic adults. Korean J Epidemiol. 2008;30:206-215. https://doi.org/10.4178/kje.2008.30.2.206
  17. Lippi G, Targher G, Montagnana M, Salvagno GL. Relationship between $\gamma$-glutamyltransferase, lipids and lipoprotein(a) in the general population. Clin Chim Acta. 2007;384:1163-1166.
  18. Kim DS, Sung HH, Cho EK, Lee JW. A study on the relationship between carotid artery intima-media thickness and clinical chemistry tests. Korean J Clin Lab Sci. 2015;47(4):188-193. https://doi.org/10.15324/kjcls.2015.47.4.188
  19. Ko HJ, Choi CS, Youn CH, Lee DH, Lee SG. The association between serum gamma-glutamyltransferase within normal range and risk factors of cardiovascular diseases: based on the framingham risk score. Korean J Obes. 2013;22(1):21-29. https://doi.org/10.7570/kjo.2013.22.1.21
  20. Kim SH, Choi HR, Won CW, Kim BS. Optimal cutoff points of anthropometric parameters to identify high coronary heart disease risk in Korean adults. J Korean Med Sci. 2016;31:61-66. https://doi.org/10.3346/jkms.2016.31.1.61
  21. Conigrave KM, Degenhardt LJ, Whitfield JB. Saunders JB, Helander A, Tabakoff B. CDT, GGT, and AST as markers of alcohol use: the WHO/ISBRA collaborative project. Alcohol Clin Exp Res. 2002;26:332-339. https://doi.org/10.1111/j.1530-0277.2002.tb02542.x
  22. Stromme JH, Rustad P, Steensland H. Theodorsen L, Urdal P. Reference intervals for eight enzymes in blood of adult females and males measured in accordance with the international federation of clinical chemistry reference system at 37 degrees C: part of the nordic reference interval project. Scand J Clin Lab Invest. 2004;64:371-384. https://doi.org/10.1080/00365510410002742
  23. Kim CH, Kim ES, Cho BC. Comparison of clinical biochemicals in sera of senior patients with hyperglycemia. Korean J Clin Lab Sci. 2012;44(2):46-51.
  24. Puukka K, Hietala J, Koivisto H, Anttila P, Bloigu R, Niemela O. Age-related changes on serum GGT activity and the assessment of ethanol intake. Alcohol Alcohol. 2006;41(5):522-527. https://doi.org/10.1093/alcalc/agl052
  25. Karlamangla A, Zhou K, Reuben D. Greendale G, Moore A. Longitudinal trajectories of heavy drinking in adults in the United States of America. Addiction. 2006;101:91-99. https://doi.org/10.1111/j.1360-0443.2005.01299.x

Cited by

  1. The Effect of the Elder's Sense of Loss on Happiness: Focused on the moderating effects of mindfulness vol.7, pp.1, 2016, https://doi.org/10.30528/jolss.2017.7.1.005