ArticleEClinicalMedicine2022
Association of gamma-glutamyltransferase levels with total mortality, liver-related and cardiovascular outcomes: A prospective cohort study in the UK Biobank.
Article in EClinicalMedicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed, 32 citations in OpenAlex.
- Distinct Liver Enzyme Profiles in Non-Diabetic Obesity: Associations with Obesity Severity and Metabolic Dysfunction.Journal of clinical medicine · 2026Article
- Sex Differences in Older Adults with Risky Alcohol Consumption: Medication Use, Comorbidities, and Hepatic Biomarkers.Nutrients · 2026Article
- Affinity Proteomics-Based Non-Invasive Detection of Clinically Significant Liver Disease.Alimentary pharmacology & therapeutics · 2026Observational
- Persistently Elevated Gamma-Glutamyl Transferase and Hepatobiliary Malignancies: A Real-World Cohort Study.Cancers · 2026Article
- Latent class analysis of association between occupational hazard factors and gamma-glutamyltransferase in automobile manufacturing workers: a cross-sectional study.Frontiers in public health · 2026Article
- Association between gamma-glutamyl transferase and risk of major adverse cardiovascular events in patients with hypertrophic cardiomyopathy: a retrospective cohort study.Frontiers in cardiovascular medicine · 2026Article
- Adaptive Ketogenic-Mediterranean Protocol (AKMP) in Real Clinical Practice: 14-Week Pre-Post Cohort Study on Glucolipid Markers and Safety.Nutrients · 2025Article
- Effectiveness of the serum ratio of l-cysteine to glutathione for the prediction of cardiovascular events.Journal of clinical biochemistry and nutrition · 2025Article
- Sex-Specific Impact of Metabolic Dysfunction-Associated Fatty Liver Disease on Incident Cardiovascular Diseases and Mortality.Endocrinology, diabetes & metabolism · 2025Article
- Relationship between endothelial activation and stress index and all-cause mortality in rheumatoid arthritis patients: a moderating effect of gamma-glutamyl transferase.Frontiers in nutrition · 2025Article
- Serum uric acid as a diagnostic biomarker for preeclampsia: comparison with renal indices and cerebroplacental ratio.Frontiers in endocrinology · 2025Article
- Routine measurement of cardiometabolic disease risk factors in primary care in England before, during, and after the COVID-19 pandemic: A population-based cohort study.PLoS medicine · 2024Article
- Pretreatment gamma-glutamyl transferase predicts mortality in patients with chronic hepatitis B treated with nucleotide/nucleoside analogs.The Kaohsiung journal of medical sciences · 2024Article
- Therapeutic effect of coenzyme-Q10 pretreatment on isoprenaline-induced cardiogenic hepatorenal complications in rats.International journal of physiology, pathophysiology and pharmacology · 2024Article
- Biomarkers of Hepatic Dysfunction and Cardiovascular Risk.Current cardiology reports · 2023Review
- Association of gamma-glutamyl transferase concentrations with all-cause and cause-specific mortality in Chinese adults with type 2 diabetes.Journal of diabetes · 2023Article
- Associations between Liver Enzymes, Lifestyle Risk Factors and Pre-Existing Medical Conditions in a Population-Based Cross-Sectional Sample.Journal of clinical medicine · 2023Article
- Significance of Fib4 index as an indicator of alcoholic hepatotoxicity in health examinations among Japanese male workers: a cross-sectional and retrospectively longitudinal study.European journal of medical research · 2023Article
Corrections and comments
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Authors and funding
12 authors at 3 institutions in 1 country.
Funding
Abstract
Background: Gamma-glutamyltransferase (GGT) levels in the blood can be a sensitive marker of liver injury but the extent to which they give insight into risk across multiple outcomes in a clinically useful way remains uncertain. Methods: Using data from 293,667 UK Biobank participants, the relationship of GGT concentrations to self-reported alcohol intake and adiposity markers were investigated. We next investigated whether GGT predicted liver-related, cardiovascular (CV) or all-cause mortality, and potentially improved CV risk prediction. Findings: Higher alcohol intake and greater waist circumference (WC) were associated with higher GGT; the association was stronger for alcohol with evidence of a synergistic effect of WC. Higher GGT concentrations were associated with multiple outcomes. Compared to a GGT of 14.5 U/L (lowest decile), values of 48 U/L for women and 60 U/L for men (common upper limits of 'normal') had hazard ratios (HRs) for liver-related mortality of 1.83 (95% CI 1.60-2.11) and 3.25 (95% CI 2.38-4.42) respectively, for CV mortality of 1.21 (95% CI 1.14-1.28) and 1.43 (95% CI 1.27-1.60) and for all-cause mortality of 1.15 (95% CI 1.12-1.18) and 1.31 (95% CI 1.24-1.38). Adding GGT to a risk algorithm for CV mortality reclassified an additional 1.24% (95% CI 0.14-2.34) of participants across a binary 5% 10-year risk threshold. Interpretation: Our study suggests that a modest elevation in GGT levels should trigger a discussion with the individual to review diet and lifestyle including alcohol intake and consideration of formal liver disease and CV risk assessment if not previously done. Funding: British Heart Foundation Centre of Research Excellence Grant (grant number RE/18/6/34217), NHS Research Scotland (grant number SCAF/15/02), the Medical Research Council (grant number MC_UU_00022/2); and the Scottish Government Chief Scientist Office (grant number SPHSU17).
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