Metabolic Syndrome, Gamma-Glutamyl Transferase, and Risk of Sudden Cardiac Death

Yun Gi Kim, Kyungdo Han, Joo Hee Jeong, Seung Young Roh, Yun Young Choi, Kyongjin Min, Jaemin Shim, Jong Il Choi, Young Hoon Kim

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


Background: Metabolic syndrome is associated with a significantly increased risk of sudden cardiac death (SCD). However, whether temporal changes in the metabolic syndrome status are associated with SCD is unknown. We aimed to determine whether metabolic syndrome and gammaglutamyl transferase (È-GTP), including their temporal changes, are associated with the risk of SCD. Methods: We performed a nationwide population-based analysis using the Korean National Health Insurance Service. People who underwent a national health check-up in 2009 and 2011 were enrolled. The influence of metabolic syndrome and È-GTP on SCD risk was evaluated. Results: In 2009, 4,056,423 (848,498 with metabolic syndrome) people underwent health screenings, 2,706,788 of whom underwent follow-up health screenings in 2011. Metabolic syndrome was associated with a 50.7% increased SCD risk (adjusted hazard ratio (aHR) = 1.507; p < 0.001). The SCD risk increased linearly as the metabolic syndrome diagnostic criteria increased. The È-GTP significantly impacted the SCD risk; the highest quartile had a 51.9% increased risk versus the lowest quartile (aHR = 1.519; p < 0.001). A temporal change in the metabolic syndrome status and È-GTP between 2009 and 2011 was significantly correlated with the SCD risk. Having metabolic syndrome in 2009 or 2011 indicated a lower SCD risk than having metabolic syndrome in 2009 and 2011 but a higher risk than having no metabolic syndrome. People with a ≥20-unit increase in È-GTP between 2009 and 2011 had an 81.0% increased SCD risk versus those with a change ≤5 units (aHR = 1.810; p < 0.001). Conclusions: Metabolic syndrome and È-GTP significantly correlated with an increased SCD risk. SCD was also influenced by temporal changes in the metabolic syndrome status and È-GTP, suggesting that appropriate medical treatment and lifestyle modifications may reduce future SCD risk.

Original languageEnglish
Article number1781
JournalJournal of Clinical Medicine
Issue number7
Publication statusPublished - 2022 Apr 1

Bibliographical note

Funding Information:
Funding: This work was supported by a National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT, Ministry of Science, and ICT) (No. 2021R1A2C2011325 to J.I.C.). The funder had no role in data collection, analysis, or interpretation, trial design, patient recruitment, or any other aspect pertinent to the study.

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.


  • Gamma-glutamyl transferase
  • Metabolic syndrome
  • Sudden cardiac death

ASJC Scopus subject areas

  • General Medicine


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