Gamma-Glutamyl Transferase Variability and Risk of Dementia in Diabetes Mellitus: A Nationwide Population-Based Study

So Hyeon Hong, Kyungdo Han, Sanghyun Park, Seon Mee Kim, Nan Hee Kim, Kyung Mook Choi, Sei Hyun Baik, Yong Gyu Park, Hye Jin Yoo

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)


Context: Gamma-glutamyl transferase (GGT) has been associated with oxidative stress and inflammatory reactions. Variability in various biomarkers has emerged as a new clinical indicator for diseases including neurodegenerative disorders. Objective: We investigated the association between GGT variability and dementia risk in patients with diabetes mellitus (DM). Design, Participants, and Methods: We used the Korean National Health Insurance Service datasets of Claims and Health Check-ups from 2004 to 2016. The risk of incident dementia (all-cause dementia, Alzheimer disease, vascular dementia) was analyzed by quartiles of GGT variability in ≥ 40-year-old DM individuals without baseline dementia. Results: During 6.12 years of follow-up, 37, 983 cases of dementia developed. In the fully adjusted model, the group with the highest quartile of GGT variability had a 19% increased risk of all-cause dementia when compared with the lowest quartile group (hazard ratio; 95% confidence interval): 1.19; 1.16-1.22, with a small effect size (Cohen d's = 0.14). Compared with the group with low baseline GGT level and the lowest quartiles of its variability, the group with high baseline GGT level and the highest quartile of its variability increased 27% of all-cause dementia. A 1 SD increment in the GGT variability was associated with a 3% increased risk of all-cause dementia. Subgroup analysis showed a more prominent association between increased GGT variability and dementia risk in men and < 60-year-old individuals (P for interaction ≤ .001). Conclusions: In subjects with DM, high variability of GGT increased the risk of dementia independently of other factors, including baseline GGT levels.

Original languageEnglish
Article numberdgaa019
JournalJournal of Clinical Endocrinology and Metabolism
Issue number3
Publication statusPublished - 2020 Jan 8

Bibliographical note

Funding Information:
Financial Support: Hye Jin Yoo was supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education (2018R1D1A1B07047587).

Publisher Copyright:
© 2020 Endocrine Society 2020.


  • Dementia
  • gamma-glutamyl transferase
  • variability

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism
  • Biochemistry
  • Endocrinology
  • Clinical Biochemistry
  • Biochemistry, medical


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