Gamma-Glutamyltransferase Is Associated with Incident Vascular Events
Fraser A, Harris R, Sattar N, et al. • Circulation
Key Finding
GGT predicts vascular events in women independently of traditional risk factors
Original title: “Gamma-glutamyltransferase is associated with incident vascular events”
Plain English Summary
This British Women's Heart and Health Study found GGT predicted incident coronary heart disease and stroke in women, even after adjusting for metabolic and lifestyle factors. The study supports GGT as a marker of vascular disease risk in women, complementing findings from predominantly male cohorts.
In-Depth Analysis
Background
Dr. Abigail Fraser and colleagues from the University of Bristol published this analysis from the British Women's Heart and Health Study in Circulation (PMID: 17353438, DOI: 10.1161/CIRCULATIONAHA.106.624858).
Study Design
Population: 3,494 women aged 60-79 years Design: Prospective cohort Follow-up: Mean 4.6 years Endpoints: Incident coronary heart disease (CHD), stroke, combined vascular events Analysis: Cox regression with adjustment for cardiovascular risk factors, alcohol, and metabolic variables
Key Findings
GGT quintiles and incident CHD:
| GGT Quintile | HR for CHD (95% CI) |
|---|---|
| Q1 (lowest) | 1.00 (reference) |
| Q2 | 1.08 (0.61-1.91) |
| Q3 | 1.25 (0.72-2.17) |
| Q4 | 1.56 (0.93-2.61) |
| Q5 (highest) | 1.86 (1.12-3.10) |
Key finding: Association persisted after adjusting for:
- •Traditional CVD risk factors
- •Alcohol consumption
- •Metabolic syndrome components
- •C-reactive protein
Mechanistic Insights
GGT may directly contribute to vascular disease through:
- •Pro-oxidant activity within atherosclerotic plaques
- •LDL oxidation catalysis
- •Marker of hepatic fat and insulin resistance
- •Reflection of systemic oxidative stress
Clinical Implications
GGT adds prognostic value in women for cardiovascular risk assessment. Elevated GGT, even within normal range, warrants attention to metabolic risk factors.
Metabolic Health Perspective
GGT elevation in women often reflects underlying metabolic dysfunction rather than alcohol use. Addressing insulin resistance and fatty liver can lower GGT while reducing vascular risk.
Paradigm Relevance
How this study applies to different clinical perspectives:
Standard Medical
Conventional clinical guidelines used by most doctors
Not directly relevant to this paradigm
Research Consensus
Current scientific understanding, often ahead of guidelines
Not directly relevant to this paradigm
Metabolic Optimization
Proactive targets for optimal health, not just disease absence
Not directly relevant to this paradigm
Study Details
- Type
- research.studyTypes.observational
Related Biomarkers
Calculate & Evaluate on Metabolicum
Related Studies
Budoff 2024: The KETO Trial Shows No Excess Plaque in High-LDL Dieters
Budoff et al. • JACC: Advances • 2024
KETO vs control: CAC median 0 vs 1 (P=0.520); total plaque score 0 vs 1 (P=0.357); 55% vs 48% zero CAC; no correlation between LDL and plaque (r=0.12, P=0.29)
Norwitz 2021: Evidence for the Lean Mass Hyper-Responder Phenotype
Norwitz et al. • Current Developments in Nutrition • 2022
LMHR criteria (18% of sample): LDL ≥200, HDL ≥80, TG ≤70 mg/dL; LMHR BMI 22.0 vs 24.6 non-LMHR (P=1.2×10⁻¹⁰); median LDL increase 146 vs 61 mg/dL
The Lipid Energy Model: Reimagining Lipoprotein Function in the Context of Carbohydrate-Restricted Diets
Norwitz et al. • Metabolites • 2022
LEM proposes carbohydrate restriction in lean individuals increases hepatic VLDL secretion with enhanced lipoprotein lipase turnover, generating elevated LDL without FH genetic markers