Predictive association between the γ-glutamyltransferase-high-density lipoprotein cholesterol ratio and all-cause mortality in the Korean genome and epidemiology study: health examinees cohort.

Objective: The ratio of γ-glutamyl transferase (GGT) and high-density lipoprotein cholesterol (HDL-C) is a novel noninsulin-based marker for assessing the risk of nonalcoholic fatty liver disease and type 2 diabetes mellitus. However, it is unclear whether the GGT/HDL-C ratio is related to all-cause mortality. Therefore, we aimed to investigate the longitudinal association of GGT/HDL-C on all-cause mortality in a large cohort of Korean adults.

Methods: Data were assessed for 87,668 participants (25,767 men and 61,901 women) from the Korean Genome and Epidemiology Study-Health Examinees cohort. These data were combined with the death certificate database from the National Statistical Office. The participants were divided into four groups according to GGT/HDL-C quartiles. We prospectively assessed hazard ratios (HRs) with 95% confidence intervals (CIs) for all-cause mortality in the 11.7 years following the baseline survey using multivariate Cox proportional hazard regression models including age, BMI, smoking status, and drinking habits, which are known to be major confounders.

Results: During the follow-up period, 3,214 individuals (3.6%; 1,728 men and 1,486 women) died. The respective HRs (95% CIs) of mortality for GGT/HDL-C quartiles 2-4 were 1.15 (0.99-1.33), 1.48 (1.28-1.71), and 1.97 (1.70-2.29) in men and 1.22 (1.02-1.45), 1.36 (1.15-1.61), and 1.69 (1.42-2.00) in women after adjusting for confounders.

Conclusions: GGT/HDL-C may be a useful predictive marker for all-cause mortality in men and women. We believe that GGT/HDL-C ratio will provide a complementary tool to help clinicians make decisions about prevention and disease management to improve survival.