Gamma-glutamyl transferase and the risk of all-cause and disease-specific mortality in patients with diabetes: A nationwide cohort study

IF 3 2区医学 Q2 ENDOCRINOLOGY & METABOLISM

Journal of Diabetes Pub Date : 2024-04-25 DOI:10.1111/1753-0407.13551

Goh Eun Chung, Su-Min Jeong, Su Jong Yu, Jeong-Ju Yoo, Yuri Cho, Kyu-na Lee, Dong Wook Shin, Yoon Jun Kim, Jung-Hwan Yoon, Kyungdo Han, Eun Ju Cho

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Abstract

Background

There exists a paucity of data regarding whether gamma-glutamyl transferase is associated with disease-specific mortality in patients with type 2 diabetes mellitus. This study aimed to investigate the association of serum gamma-glutamyl transferase levels with all-cause and disease-specific mortality in patients with diabetes mellitus using a Korean nationwide health-screening database.

Methods

A total of 9 687 066 patients without viral hepatitis or liver cirrhosis who underwent health examination in 2009 were included. These patients were divided into four groups according to sex-specific quartiles of serum gamma-glutamyl transferase levels.

Results

During a median follow-up period of 8.1 years, 222 242 deaths were identified. The all-cause mortality rate increased as the serum gamma-glutamyl transferase levels became higher (highest quartile vs lowest quartile: hazard ratio [HR], 1.57; 95% confidence interval [CI], 1.55–1.59; p for trend <.001). Similar trends were observed for cardiovascular disease (HR, 1.57; 95% CI, 1.53–1.62), ischemic heart disease (HR, 1.40; 95% CI, 1.33–1.48), and stroke (HR, 1.72; 95% CI, 1.60–1.85) in the highest quartile, as compared with the lowest quartile (p for trend <.001). As the gamma-glutamyl transferase quartiles became higher, mortality rates related to cancer (HR, 1.56; 95% CI, 1.52–1.60), liver disease (HR, 9.42; 95% CI, 8.81–10.07), respiratory disease (HR, 1.55; 95% CI, 1.49–1.62), and infectious disease (HR, 1.73; 95% CI, 1.59–1.87) also increased in the highest quartile, compared with the lowest quartile (p for trend <.001).

Conclusions

Serum gamma-glutamyl transferase levels may be useful for the risk assessment of all-cause and disease-specific mortality among patients with type 2 diabetes mellitus.

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γ-谷氨酰转移酶与糖尿病患者的全因和特定疾病死亡风险：全国性队列研究

背景有关γ-谷氨酰转移酶是否与2型糖尿病患者的疾病特异性死亡率有关的数据很少。本研究旨在利用韩国全国健康筛查数据库，调查血清γ-谷氨酰转移酶水平与糖尿病患者全因死亡率和疾病特异性死亡率的关系。方法共纳入 9 687 066 名在 2009 年接受健康检查的无病毒性肝炎或肝硬化患者。根据血清γ-谷氨酰转移酶水平的性别特异性四分位数将这些患者分为四组。结果在中位 8.1 年的随访期间，共发现 222 242 例死亡病例。血清γ-谷氨酰转移酶水平越高，全因死亡率越高（最高四分位数与最低四分位数：危险比[HR]，1.57；95%置信区间[CI]，1.55-1.59；趋势 p<.001）。在心血管疾病（HR，1.57；95% CI，1.53-1.62）、缺血性心脏病（HR，1.40；95% CI，1.33-1.48）和中风（HR，1.72；95% CI，1.60-1.85）方面，最高四分位数与最低四分位数相比也观察到类似的趋势（p 为趋势 <.001）。随着γ-谷氨酰转移酶四分位数越高，癌症（HR，1.56；95% CI，1.52-1.60）、肝脏疾病（HR，9.42；95% CI，8.81-10.07）、呼吸系统疾病（HR，1.55；95% CI，1.49-1.62）和传染病（HR，1.73；95% CI，1.59-1.87）的死亡率在最高四分位数也比最低四分位数高（p为趋势<.001）。结论血清γ-谷氨酰转移酶水平可能有助于对2型糖尿病患者的全因死亡率和疾病特异性死亡率进行风险评估。

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来源期刊

Journal of Diabetes ENDOCRINOLOGY & METABOLISM-

CiteScore

6.50

自引率

2.20%

发文量

审稿时长

>12 weeks

期刊介绍： Journal of Diabetes (JDB) devotes itself to diabetes research, therapeutics, and education. It aims to involve researchers and practitioners in a dialogue between East and West via all aspects of epidemiology, etiology, pathogenesis, management, complications and prevention of diabetes, including the molecular, biochemical, and physiological aspects of diabetes. The Editorial team is international with a unique mix of Asian and Western participation. The Editors welcome submissions in form of original research articles, images, novel case reports and correspondence, and will solicit reviews, point-counterpoint, commentaries, editorials, news highlights, and educational content.