1. Frequently abnormal serum gamma-glutamyl transferase activity is associated with future development of fatty liver: a retrospective cohort study
- Author
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Takeshi Nishimura, Toru Kadono, Etsuko Kishimoto, Hiroyuki Kimura, Tetsuhisa Ko, Reo Kobayashi, Nami Nakabe, Yoshikazu Nakatsugawa, Hideki Fujii, Kohei Asaeda, Hideki Sato, Shinya Yamada, Haruna Doi, Yusuke Okuyama, Takahiro Nakano, Toshifumi Doi, Takatomo Shima, Taito Fukuma, and Naoya Tomatsuri
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Incidence rate ,Gastroenterology ,digestive system ,Triglyceride ,Gamma-glutamyl transferase ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Liver Function Tests ,Non-alcoholic Fatty Liver Disease ,Internal medicine ,Fatty liver ,Nonalcoholic fatty liver disease ,medicine ,Humans ,lcsh:RC799-869 ,Retrospective Studies ,business.industry ,Albumin ,Retrospective cohort study ,Alanine Transaminase ,General Medicine ,gamma-Glutamyltransferase ,Hepatology ,medicine.disease ,digestive system diseases ,030104 developmental biology ,chemistry ,030211 gastroenterology & hepatology ,lcsh:Diseases of the digestive system. Gastroenterology ,business ,Body mass index ,Lipoprotein ,Research Article - Abstract
Background Nonalcoholic fatty liver disease is characterized by excessive hepatic fat accumulation. Some individuals frequently present elevated gamma-glutamyl transferase (GGT) levels without fatty liver ultrasound images and other abnormal liver enzymes levels. However, whether these individuals are at an elevated risk for developing fatty liver is unclear. We compared fatty liver change rates and risk factors between individuals with frequently elevated GGT levels and those with normal levels. Methods We designed a retrospective cohort study on the basis of complete medical checkup records. One group of individuals had presented normal serum GGT levels during the observation period (Normal-GGT group, n = 2713). Another group had had abnormal elevated serum GGT levels frequently (Abnormal-GGT group, n = 264). We determined the fatty liver change incident rates before and after propensity score matching. We explored confounding factors affecting fatty changes in each group using univariate and multivariate Cox models. Results The change incidence rates were 5.80/1000 and 10.02/1000 person-years in the Normal-GGT and Abnormal-GGT groups, respectively. After propensity score matching, the incidence rates were 3.08/1000 and 10.18/1000 person-years in the Normal-GGT and Abnormal-GGT groups, respectively (p = 0.026). The factors associated with fatty liver changes in the Normal-GGT group included body mass index (BMI), hemoglobin, alanine aminotransferase (ALT), albumin, triglyceride (TG), fasting blood sugar, and high-density lipoprotein levels. Those in the Abnormal-GGT group were platelet counts and TG. In our multivariable analysis, BMI, ALT, albumin, and TG levels were independent predictors of fatty changes in the Normal-GGT group, and high TG level was the only independent predictor in the Abnormal-GGT group. Conclusions The incidence rate of fatty liver change in the Abnormal-GGT group was higher than that in the Normal-GGT group. Consecutive elevated GGT levels increase the risk for fatty liver, and high TG levels in those individuals further independently increase the risk.
- Published
- 2020
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