TY - JOUR
T1 - Gamma-glutamyl transferase predicts future stroke
T2 - A Korean nationwide study
AU - Yang, Wookjin
AU - Kim, Chi Kyung
AU - Kim, Do Yeon
AU - Jeong, Han Gil
AU - Lee, Seung Hoon
N1 - Funding Information:
This work was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health and Welfare, Republic of Korea (HI17C0076); the Basic Science Research Program through the National Research Foundation of Korea, funded by the Ministry of Science and ICT (NRF-2015R1A2A2A01007770); and an R&D support grant (O1700451) from Korea University Guro Hospital, Republic of Korea. We thank Dong-Wan Kang and Eun-Sun Park for assistance with data acquisition and review; and the Medical Research Collaborating Center at Seoul National University Hospital and Pf. Seung-sik Hwang for providing statistical advice.
Funding Information:
This work was supported by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health and Welfare, Republic of Korea (HI17C0076); the Basic Science Research Program through the National Research Foundation of Korea, funded by the Ministry of Science and ICT (NRF-2015R1A2A2A01007770); and an R&D support grant (O1700451) from Korea University Guro Hospital, Republic of Korea.
Publisher Copyright:
© 2018 American Neurological Association
PY - 2018/2/1
Y1 - 2018/2/1
N2 - Objective: Although gamma-glutamyl transferase (GGT) is generally regarded as an alternative biomarker for alcohol consumption, its independent role in vascular diseases emerged recently. However, its role in stroke remains unknown. The aim of this study is to clarify the impact of GGT on stroke in a large-sized, national, standardized population cohort in Korea. Methods: In Korea, the National Health Insurance Service (NHIS) provides full-coverage health insurance service for all citizens. Using data from the NHIS, the NHIS–National Sample Cohort was designed by randomly selecting 2% of Koreans, carefully considering demographic characteristics. We analyzed eligible individuals from this standardized cohort. The Cox proportional hazards model was used for the study investigating the relationship between GGT and stroke. Results: Among the 456,100 eligible participants, 7,459 patients (1.64%) developed stroke as follows: 5,789 ischemic strokes, 1,046 intracerebral hemorrhages (ICHs), and 624 subarachnoid hemorrhages. GGT was independently correlated with increased risk of stroke after adjustment for alcohol consumption and stroke risk factors (hazard ratio [HR] = 1.39, 95% confidence interval [CI] = 1.29–1.51). The risks of both ischemic stroke (HR = 1.45, 95% CI = 1.32–1.58) and ICH (HR = 1.46, 95% CI = 1.18–1.80) were significantly elevated with increasing GGT. Despite some effect modifications by sex, age, and alcohol, the risk of total stroke and ischemic stroke in association with GGT remained significant in all subgroups. Interpretation: In a standard Korean population, GGT was a novel biomarker predicting stroke risk, independently from alcohol consumption and other risk factors. Ann Neurol 2018;83:375–386.
AB - Objective: Although gamma-glutamyl transferase (GGT) is generally regarded as an alternative biomarker for alcohol consumption, its independent role in vascular diseases emerged recently. However, its role in stroke remains unknown. The aim of this study is to clarify the impact of GGT on stroke in a large-sized, national, standardized population cohort in Korea. Methods: In Korea, the National Health Insurance Service (NHIS) provides full-coverage health insurance service for all citizens. Using data from the NHIS, the NHIS–National Sample Cohort was designed by randomly selecting 2% of Koreans, carefully considering demographic characteristics. We analyzed eligible individuals from this standardized cohort. The Cox proportional hazards model was used for the study investigating the relationship between GGT and stroke. Results: Among the 456,100 eligible participants, 7,459 patients (1.64%) developed stroke as follows: 5,789 ischemic strokes, 1,046 intracerebral hemorrhages (ICHs), and 624 subarachnoid hemorrhages. GGT was independently correlated with increased risk of stroke after adjustment for alcohol consumption and stroke risk factors (hazard ratio [HR] = 1.39, 95% confidence interval [CI] = 1.29–1.51). The risks of both ischemic stroke (HR = 1.45, 95% CI = 1.32–1.58) and ICH (HR = 1.46, 95% CI = 1.18–1.80) were significantly elevated with increasing GGT. Despite some effect modifications by sex, age, and alcohol, the risk of total stroke and ischemic stroke in association with GGT remained significant in all subgroups. Interpretation: In a standard Korean population, GGT was a novel biomarker predicting stroke risk, independently from alcohol consumption and other risk factors. Ann Neurol 2018;83:375–386.
UR - http://www.scopus.com/inward/record.url?scp=85041495948&partnerID=8YFLogxK
U2 - 10.1002/ana.25158
DO - 10.1002/ana.25158
M3 - Article
C2 - 29372929
AN - SCOPUS:85041495948
SN - 0364-5134
VL - 83
SP - 375
EP - 386
JO - Annals of Neurology
JF - Annals of Neurology
IS - 2
ER -