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Eur J Prev Cardiol. 2014 Dec;21(12):1541-8. doi: 10.1177/2047487313501967. Epub 2013 Aug 14.

Gamma-glutamyltransferase, insulin resistance and cardiometabolic risk profile in a middle-aged African population.

Author information

1
Department of Biomedical Technology, Cape Peninsula University of Technology, South Africa.
2
Division of Chemical Pathology, University of Stellenbosch, South Africa.
3
NCRP for Cardiovascular and Metabolic Diseases, South African Medical Research Council and University of Cape Town, South Africa andre.kengne@mrc.ac.za.

Abstract

BACKGROUND:

Mechanisms linking liver functions with cardiometabolic risk may involve insulin resistance (IR) and non-alcoholic fatty liver disease. We assessed the associations of gamma-glutamyltransferase (GGT) levels with IR and metabolic syndrome (MetS) in an adult South African urban cohort.

METHODS:

1198 participants aged >15 years (297 men) were drawn from the Bellville-South suburb (Cape Town). The homeostatic model assessment of insulin (HOMA-IR), β-cells function (HOMA-B%), fasting insulin resistance index (FIRI) and the quantitative insulin-sensitivity check index (QUICKI) were calculated, and MetS defined according to the Join Interim Statement 2009 criteria. Associations of GGT levels with covariates were assessed on a continuous scale and across sex-specific quarters of GGT, with adjustment for confounders via generalized linear and logistic regressions.

RESULTS:

Indicators of IR (HOMA-IR, FIRI and fasting insulin) increased, whereas those for insulin sensitivity (Sib and QUICKI) diminished significantly linearly and across increasing GGT quarters. In multivariable-adjusted models, adjustment for sex, age, BMI, cigarette smoking and alcohol intake yielded the strongest, significant associations between GGT and all markers of IR/IS and glycemia excluding glucose insulin ratio. In a similar level of adjustments, with/without further adjustment for markers of IR/insulin sensitivity, the prevalence of MetS significantly increased across quarters of GGT.

CONCLUSIONS:

GGT levels were independently associated with insulin sensitivity and MetS in this population. Unaccounted, chronic elevation of GGT may therefore be a cue to screen and monitor individuals for MetS and diabetes, and may warrant consideration as an indicator of high risk for the development of these metabolic disorders.

KEYWORDS:

Gamma-glutamyltransferase; South Africa; cardiovascular risk; insulin resistance; metabolic syndrome

PMID:
23945039
DOI:
10.1177/2047487313501967
[Indexed for MEDLINE]

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