Journal of Preventive Medicine and Public Health

Original Articles

Mercury Exposure in Association With Decrease of Liver Function in Adults: A Longitudinal Study: Jonghyuk Choi, Sanghyuk Bae, Hyungryul Lim, Ji-Ae Lim, Yong-Han Lee, Mina Ha, Ho-Jang Kwon; J Prev Med Public Health. 2017;50(6):377-385. Published online November 7, 2017; DOI: https://doi.org/10.3961/jpmph.17.099

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Objectives
Although mercury (Hg) exposure is known to be neurotoxic in humans, its effects on liver function have been less often reported. The aim of this study was to investigate whether total Hg exposure in Korean adults was associated with elevated serum levels of the liver enzymes aspartate aminotransferase (AST), alanine transaminase (ALT), and gamma-glutamyltransferase (GGT).
Methods
We repeatedly examined the levels of total Hg and liver enzymes in the blood of 508 adults during 2010-2011 and 2014-2015. Cross-sectional associations between levels of blood Hg and liver enzymes were analyzed using a generalized linear model, and nonlinear relationships were analyzed using a generalized additive mixed model. Generalized estimating equations were applied to examine longitudinal associations, considering the correlations of individuals measured repeatedly.
Results
GGT increased by 11.0% (95% confidence interval [CI], 4.5 to 18.0%) in women and 8.1% (95% CI, -0.5 to 17.4%) in men per doubling of Hg levels, but AST and ALT were not significantly associated with Hg in either men or women. In women who drank more than 2 or 3 times per week, AST, ALT, and GGT levels increased by 10.6% (95% CI, 4.2 to 17.5%), 7.7% (95% CI, 1.1 to 14.7%), and 37.5% (95% CI,15.2 to 64.3%) per doubling of Hg levels, respectively, showing an interaction between blood Hg levels and drinking.
Conclusions
Hg exposure was associated with an elevated serum concentration of GGT. Especially in women who were frequent drinkers, AST, ALT, and GGT showed a significant increase, with a significant synergistic effect of Hg and alcohol consumption.

Summary

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A Cross-Sectional Study on gamma-GTP and its Related Factors in Male Workers.: Keon Yeop Kim, Sin Kam, Jong Hyun Lee, Young Ae Ha, Kyung Eun Lee; Korean J Prev Med. 2002;35(2):169-174.

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Abstract PDF: OBJECTIVE
To investigate gamma-Glutamyltransferase (gamma-GTP) and its related factors in male industrial workers. METHOD: Five hundred and forty male workers without heart disease, diabetes mellitus, renal disease, hepatitis, and other liver diseases were surveyed in October 1998. Blood samples were collected to test for gamma-GTP, total-cholesterol and fasting blood glucose. A self-administered questionnaire survey on life style was also done. RESULTS: The total geometric mean value of gamma-GTP was 30.6 U/L. According to a univariate analysis: age, BMI(body mass index, kg/m2), alcohol consumption, current smoking, stress, diastolic blood pressure, and blood total cholesterol were significantly associated with gamma-GTP(p<0.05). From a multiple regression analysis: BMI, alcohol consumption, current smoking, diastolic blood pressure and total-cholesterol were significantly related to gamma-GTP(p<0.05). Coffee consumption was negatively related to gamma-GTP, but not significantly. CONCLUSION: We recommend that a change in health behavior (i.e. reducing alcohol intake, controlling BMI and not smoking) is necessary to decrease gamma-GTP in male workers.; Summary

English Abstracts

Association Between Gamma-Glutamyltransferase and Hypertension Incidence in Rural Prehypertensive Adults.: Jun Hyun Hwang, Ji Yeon Shin, Byung yeol Chun, Duk Hee Lee, Keon Yeop Kim, Wee hyun Park, Shung chull Chae; J Prev Med Public Health. 2010;43(1):18-25.; DOI: https://doi.org/10.3961/jpmph.2010.43.1.18

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Abstract PDF

OBJECTIVES
Prehypertension is associated with a higher risk of developing hypertension compared with normotension. Yet, factors predicting the development of hypertension among prehypertensive people are ill-understood. This prospective cohort study was performed to examine if serum gamma-glutamyltrasferase (GGT) within a normal range can predict the future risk of hypertension among prehypertensive adults. METHODS: Study subjects were 293 prehypertensive persons >30-years-of-age who participated in a community-based health survey in 2003 and who were followed up in 2008. Sex-specific quartiles of baseline serum GGT were used to examine association with 5-year hypertension incidence. RESULTS: Baseline serum GGT within normal range predicted the risk of developing hypertension for 5 years only in prehypertensive women. Adjusted relative risks were 1.0, 3.7, 3.6, and 6.0 according to quartiles of baseline serum GGT (P for trend <0.01). This pattern was similarly observed in non-drinkers. However, serum GGT was not associated with incident hypertension in men. Different from serum GGT, baseline serum alanine aminotransferase, another well-known liver enzyme, did not predict the risk of incident hypertension in both genders. CONCLUSIONS: Even though baseline serum GGT within normal range strongly predicted the future risk of hypertension, it was observed only in women, Although underlying mechanisms of this association are currently unclear, serum GGT can be used to select a high risk group of hypertension in prehypertensive women.

Summary

Citations

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Gamma-glutamyltransferase and risk of hypertension
Setor K. Kunutsor, Tanefa A. Apekey, Bernard M.Y. Cheung
Journal of Hypertension.2015; 33(12): 2373. CrossRef
Endobiogeny: A Global Approach to Systems Biology (Part 1 of 2)
Jean-Claude, Lapraz, Kamyar M. Hedayat
Global Advances in Health and Medicine.2013; 2(1): 64. CrossRef
Gamma-Glutamyltransferase Level and Risk of Hypertension: A Systematic Review and Meta-Analysis
Cun-Fei Liu, Yu-Ting Gu, Hai-Ya Wang, Ning-Yuan Fang, Antony Bayer
PLoS ONE.2012; 7(11): e48878. CrossRef
Association between γ-glutamyltransferase and prehypertension
XUZHEN QIN, GUODONG TANG, LING QIU, TAO XU, XINQI CHENG, SHAOMEI HAN, GUANGJIN ZHU, YAJUN LIU
Molecular Medicine Reports.2012; 5(4): 1092. CrossRef

The Association of Central Obesity with Type 2 Diabetes among Koreans according to the Serum Gamma-Glutamyltransferase Level: Korean Genome and Epidemiology Study.: Ji Yeon Shin, Jun Hyun Hwang, Jin Young Jeong, Sung Hi Kim, Jai Dong Moon, Sang Chul Roh, Young Wook Kim, Yangho Kim, Jong Han Leem, Young Su Ju, Young Seoub Hong, Eun Hee Ha, Yong Hwan Lee, Duk Hee Lee, Dong Hyun Kim; J Prev Med Public Health. 2009;42(6):386-391.; DOI: https://doi.org/10.3961/jpmph.2009.42.6.386

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Abstract PDF

OBJECTIVES
This cross-sectional study was performed to examine if the serum gamma-glutamyltransferase (GGT) level that is within its normal range is associated with the risk of type 2 diabetes and if the association between the waist hip ratio (WHR) and type 2 diabetes is different depending on the serum GGT levels. METHODS: The study subjects were 23,436 persons aged 40 years or older and who participated in regular health check-ups at 11 hospitals (males: 5,821, females: 17,615). The gender-specific quintiles of the serum GGT and WHR were used to examine the associations with type 2 diabetes. RESULTS: The serum GGT levels within their normal range were positively associated with type 2 diabetes only in women. The adjusted odds ratios (ORs) were 1.0, 1.0, 1.4, 2.1, and 2.5 according to the quintiles of the serum GGT (p(trend)<0.01). The WHR was more strongly associated with the prevalence of diabetes among the women with a high-normal serum GGT level as compared with those with a low-normal serum GGT level (p for interaction=0.02). For example, the adjusted ORs for women with a low normal serum GGT level were 1.0, 1.2, 1.5, 2.2, and 2.4 according to the quintiles of the WHR, while those figures were 1.0, 2.4, 3.6, 5.0, and 8.3 among the women with a high normal serum GGT level. However, in men, the serum GGT was very weakly associated with type 2 diabetes and the association between the WHR and type 2 diabetes was not different depending on the serum GGT level. CONCLUSIONS: Serum GGT within its normal range was positively associated with type 2 diabetes, and central obesity was more strongly associated with the prevalence of type 2 diabetes when the serum GGT level was high-normal. However, these associations were observed only in women, which is different from the previous findings. The stronger relation between central obesity and type 2 diabetes among women with a high-normal serum GGT level can be useful for selecting a group that is at high risk for type 2 diabetes irregardless of whatever the underlying mechanism is.

Summary

Citations

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Serum gamma-glutamyl transferase and risk of type 2 diabetes in the general Korean population: a Mendelian randomization study
Youn Sue Lee, Yoonsu Cho, Stephen Burgess, George Davey Smith, Caroline L. Relton, So-Youn Shin, Min-Jeong Shin
Human Molecular Genetics.2016; 25(17): 3877. CrossRef
Different associations between obesity and impaired fasting glucose depending on serum gamma-glutamyltransferase levels within normal range: a cross-sectional study
Nam Soo Hong, Jeong-Gook Kim, Yu-Mi Lee, Hyun-Woo Kim, Sin Kam, Keon-Yeop Kim, Ki-Su Kim, Duk-Hee Lee
BMC Endocrine Disorders.2014;[Epub] CrossRef
Endobiogeny: A Global Approach to Systems Biology (Part 1 of 2)
Jean-Claude, Lapraz, Kamyar M. Hedayat
Global Advances in Health and Medicine.2013; 2(1): 64. CrossRef

The Association between Serum GGT Level within Normal Range and Risk Factors of Cardiovascular Diseases.: Ji Seun Lim, Yu Jin Kim, Byung Yeol Chun, Jin Hoon Yang, Duk Hee Lee, Sin Kam; J Prev Med Public Health. 2005;38(1):101-106.

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Abstract PDF: OBJECTIVES
We conducted this study to examine the association between serum GGT levels within the normal range and the risk factors of cardiovascular diseases METHODS: We examined the cross-sectional association between serum GGT and the systolic and diastolic blood pressure, fasting blood glucose, total cholesterol, triglyceride, high density lipoprotein cholesterol (HDL-cholesterol), and uric acid among 975 subjects that participated in the health examination of a university hospital located in Daegu city. All the patients' GGT levels were within the normal range. RESULTS: After adjustment were made for age, body mass index (BMI), smoking status, drinking frequency, exercise frequency and coffee intake, the serum GGT level was positively associated with fasting blood glucose (p< 0.01), total cholesterol (p< 0.01), and triglyceride (p< 0.01) in men, and it was positively associated with fasting blood glucose (p< 0.01), total cholesterol (p< 0.05), triglyceride (p< 0.01), and uric acid (p< 0.01) in women. The associations were not significantly different depending on the status of alcohol drinking or obesity, except for the associations of serum GGT with diastolic blood pressure (P for interaction=0.04) and uric acid (P for interaction=0.04) between the lean and obese subjects. CONCLUSIONS: Serum GGT levels within the normal range were positively associated with fasting blood glucose, triglyceride and uric acid in most subgroups irrespective of the drinking or obesity status. These results suggest that GGT has important clinical implications as being more than just a marker of alcohol consumption and hepatobiliary disease.; Summary

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