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Cited by 321Liver Disease Diagnosis and TreatmentDiabetes, Cardiovascular Risks, and LipoproteinsDiet, Metabolism, and Disease

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Prospective Study of Serum γ-Glutamyltransferase and Risk of NIDDM

Perry, Ivan J, Wannamethee, S Goya, Shaper, A Gerald·1998·Diabetes Care
DOI 10.2337/diacare.21.5.732
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Abstract

OBJECTIVE: Serum gamma-glutamyltransferase (GGT) levels are raised in obese individuals, and a particularly strong association with central obesity has been described. We hypothesized that elevated GGT levels are a marker for visceral fat, and specifically for hepatic steatosis (fatty liver), and that hepatic steatosis leads to hepatic insulin resistance. To test this hypothesis, we examined the association between GGT levels and risk of NIDDM. RESEARCH DESIGN AND METHODS: We carried out a prospective cohort study of incident cases of doctor-diagnosed NIDDM in a group of 7,458 nondiabetic men (aged 40-59 years) followed for a mean of 12.8 years (range 11.5-13.0). The men were randomly selected from general practice lists in 24 British towns. Cases of NIDDM were ascertained by repeated postal questionnaires to the men and by regular systematic review of primary care records. RESULTS: A total of 194 men developed NIDDM during follow-up. Mean serum GGT at baseline (geometric mean [95% CI]) was significantly higher in the NIDDM patients than in the rest of the cohort (20.9 [19.3-22.6] vs. 15.3 U/l [15.0-15.6], P < 0.0001). There was a smooth, graded increase in the age-adjusted risk of NIDDM with increasing GGT levels, with a relative risk in the top fifth of the distribution of 6.8 (3.5-12.9) relative to the bottom fifth (trend P < 0.0001). This association was independent of serum glucose and BMI and of other predictors of NIDDM with which GGT is associated, including alcohol intake and physical activity level (adjusted upper to lower fifth relative risk: 4.8 [2.0-11.8], trend P < 0.0001]). CONCLUSIONS: These findings suggest that a raised serum GGT level is an independent risk factor for NIDDM. Serum GGT level may be a simple and reliable marker of visceral and hepatic fat and, by inference, of hepatic insulin resistance.

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Metadata

Authors
Perry, I. J., Wannamethee, S. G., & Shaper, A. G.
Affiliations
The Royal Free Hospital (GB)
ORCID
Venue
Diabetes Care
Publisher
American Diabetes Association
Published
1998-05-01
Volume
21
Issue
5
Pages
732-737
ISSN
  • 0149-5992 (ISSN-L)
  • 1935-5548
DOI
10.2337/diacare.21.5.732
OpenAlex
W2146589543
Cited by
319
References
0
Citations by year
2026: 2 · 2025: 5 · 2024: 6 · 2023: 5 · 2022: 2 · 2021: 2 · 2020: 10 · 2019: 1 · 2018: 8 · 2017: 10 · 2016: 14 · 2015: 5 · 2014: 15 · 2013: 13 · 2012: 18
FWCI
5.21
Type
journal article
Language
en
Open access
closed
Locations
  • Diabetes Care (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Funders
Wellcome Trust
Topics
  • Health Sciences › Medicine › Hepatology › Liver Disease Diagnosis and Treatment
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diet, Metabolism, and Disease
Keywords
gamma-glutamyl transferase, type 2 diabetes, type 2 diabetes risk, hepatic steatosis, visceral fat, hepatic insulin resistance, biomarkers, alcohol consumption, physical activity, obesity, men
MeSH terms
Adult, Alcohol Drinking, Alkaline Phosphatase, Aspartate Aminotransferases, Diabetes Mellitus, Type 2, Follow-Up Studies, gamma-Glutamyltransferase, United Kingdom, Humans, Liver, Male, Middle Aged, Obesity, Predictive Value of Tests, Prospective Studies, Risk Factors, Body Mass Index, Incidence, Multivariate Analysis

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