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Journal of Preventive Medicine and Public Health 2006;39(4): 353-358.
Serum Gamma-glutamyltransferase Levels and the Risks of Impaired Fasting Glucose in Healthy Men: A 2-year Follow-up.
Joo Youn Shin, Jong Han Lim, Dai Ha Koh, Keun Sang Kwon, Yong Kyu Kim, Hwan Chul Kim, Yeui Cheol Lee, Ju Hyoung Lee, Moon Suk Nam, Sung Bin Hong, Shin Goo Park
1Gwangju Regional Labor Office, Ministry of Labor, Korea.
2Department of Occupational and Environmental Medicine, Inha University Hospital, Korea. oem@inha.ac.kr
3Department of Preventive Medicine, College of Medicine, Chonbuk National University, Korea.
4Industrial Medical Center, The Catholic University of Korea, Korea.
5Department of Internal Medicine, Inha University Hospital, Korea.
OBJECTIVES: An increase in the serum gammaglutamyltransferase (GGT) concentration has been regarded as a marker of alcohol drinking or liver disease. Some reports, however, have suggested that the serum GGT may be a sensitive and early biomarker for the development of prediabetes and diabetes. In this study we investigated whether serum GGT is a reliable predictor of the incident impaired fasting glucose (IFG), including diabetes. METHODS: We performed a prospective study for two years (2002-2004). We analyzed the periodic health examination data from a total of 4,711 men. The examinations were done in the years 2002 and 2004. The analyzed data included a self-questionnaire, a physical examination and the laboratory results. Both IFG and diabetes were defined as a serum fasting glucose concentration of more than 100 mg/dL and 126 mg/dL, respectively. RESULTS: A total of 738 cases (15.7%) of incident IFG and 13 cases (0.3%) of diabetes occurred. The mean serum GGT concentrations were quite different between the normal (38.0 IU) and incident IFG groups (50.3 IU), and the incident diabetes group (66.0 IU) (p <0.001). After multivariable adjustment, the relative risks for incident IFG or diabetes across the baseline GGT categories (<10th, 10th-20th, 30th-40th, 50th-60th, 70th-80th and >90th percentile) were 1.0, 1.172 (0.769-1.785), 1.107 (0.725- 1.689), 1.444 (0.934-2.232), 2.061 (1.401-3.031) and 2.545 (1.784-3.631) (p-value for trend: <0.001). The risks significantly increased with increasing levels of GGT for 2 years; when comparing the increased groups (<10%, 10- 20%, >20%) versus the decreased over 20% group of GGT, the risks for IFG or diabetes were 1.334 (1.002-1.776), 1.613 (1.183-2.199) and 1.399 (1.092-1.794). CONCLUSIONS: Our findings suggest that serum GGT concentrations within its normal range may be an early predictor of the development of IFG and diabetes. As serum GGT is a relatively inexpensive test and a reliable marker, it might have important implications in public health promotion.
Key words: Impaired fasting glucose; Prediabetes; Diabetes; Gamma glutamyltransferase
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