Affiliation:
1. Department of Internal Medicine and Healthcare Research Institute Seoul National University Hospital Healthcare System Gangnam Center Seoul Republic of Korea
2. Department of Medicine Seoul National University College of Medicine Seoul Republic of Korea
3. Department of Internal Medicine and Liver Research Institute Seoul National University College of Medicine Seoul Republic of Korea
4. Department of Internal Medicine, Division of Gastroenterology and Hepatology Soonchunhyang University Bucheon Hospital Gyeonggi‐do Republic of Korea
5. Center for Liver and Pancreatobiliary Cancer National Cancer Center Goyang Republic of Korea
6. Department of Biomedicine & Health Science The Catholic University of Korea Seoul Korea
7. Department of Clinical Research Design and Evaluation/Department of Digital Health Samsung Advanced Institute for Health Science Seoul Republic of Korea
8. Department of Biostatistics College of Medicine, Soongsil University Seoul Republic of Korea
Abstract
AbstractBackgroundThere exists a paucity of data regarding whether gamma‐glutamyl transferase is associated with disease‐specific mortality in patients with type 2 diabetes mellitus. This study aimed to investigate the association of serum gamma‐glutamyl transferase levels with all‐cause and disease‐specific mortality in patients with diabetes mellitus using a Korean nationwide health‐screening database.MethodsA total of 9 687 066 patients without viral hepatitis or liver cirrhosis who underwent health examination in 2009 were included. These patients were divided into four groups according to sex‐specific quartiles of serum gamma‐glutamyl transferase levels.ResultsDuring a median follow‐up period of 8.1 years, 222 242 deaths were identified. The all‐cause mortality rate increased as the serum gamma‐glutamyl transferase levels became higher (highest quartile vs lowest quartile: hazard ratio [HR], 1.57; 95% confidence interval [CI], 1.55–1.59; p for trend <.001). Similar trends were observed for cardiovascular disease (HR, 1.57; 95% CI, 1.53–1.62), ischemic heart disease (HR, 1.40; 95% CI, 1.33–1.48), and stroke (HR, 1.72; 95% CI, 1.60–1.85) in the highest quartile, as compared with the lowest quartile (p for trend <.001). As the gamma‐glutamyl transferase quartiles became higher, mortality rates related to cancer (HR, 1.56; 95% CI, 1.52–1.60), liver disease (HR, 9.42; 95% CI, 8.81–10.07), respiratory disease (HR, 1.55; 95% CI, 1.49–1.62), and infectious disease (HR, 1.73; 95% CI, 1.59–1.87) also increased in the highest quartile, compared with the lowest quartile (p for trend <.001).ConclusionsSerum gamma‐glutamyl transferase levels may be useful for the risk assessment of all‐cause and disease‐specific mortality among patients with type 2 diabetes mellitus.image
Funder
Seoul National University Hospital