Alcohol, metabolic risk and elevated serum gamma-glutamyl transferase (GGT) in Indigenous Australians.

Matthew T Haren,John Petkov,Ming Li,Robyn A Mcdermott

doi:10.1186/1471-2458-10-454

Matthew T Haren, John Petkov + Show 2 more

Open Access

https://doi.org/10.1186/1471-2458-10-454

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Abstract

BackgroundThe interaction between overweight/obesity and alcohol intake on liver enzyme concentrations have been demonstrated. No studies have yet examined the interaction between metabolic syndrome or multiple metabolic risk factors and alcohol intake on liver enzymes. The aim of this study was to examine if alcohol consumption modifies the effect of metabolic risk on elevated serum GGT in Indigenous Australians.MethodsData were from N = 2609 Indigenous Australians who participated in a health screening program in rural far north Queensland in 1999-2000 (44.5% response rate). The individual and interactive effects of metabolic risk and alcohol drinking on elevated serum GGT concentrations (≥50 U/L) were analyzed using logistic regression.ResultsOverall, 26% of the population had GGT≥50 U/L. Elevated GGT was associated with alcohol drinking (moderate drinking: OR 2.3 [95%CI 1.6 - 3.2]; risky drinking: OR 6.0 [4.4 - 8.2]), and with abdominal obesity (OR 3.7 [2.5 - 5.6]), adverse metabolic risk cluster profile (OR 3.4 [2.6 - 4.3]) and metabolic syndrome (OR 2.7 [2.1 - 3.5]) after adjustment for age, sex, ethnicity, smoking, physical activity and BMI. The associations of obesity and metabolic syndrome with elevated GGT were similar across alcohol drinking strata, but the association of an adverse metabolic risk cluster profile with elevated GGT was larger in risky drinkers (OR 4.9 [3.7 - 6.7]) than in moderate drinkers (OR 2.8 [1.6 - 4.9]) and abstainers (OR 1.6 [0.9 - 2.8]).ConclusionsIn this Indigenous population, an adverse metabolic profile conferred three times the risk of elevated GGT in risky drinkers compared with abstainers, independent of sex and ethnicity. Community interventions need to target both determinants of the population's metabolic status and alcohol consumption to reduce the risk of elevated GGT.

Highlights

The interaction between overweight/obesity and alcohol intake on liver enzyme concentrations have been demonstrated
The Australian indigenous population has an excess of metabolic syndrome and type 2 diabetes relative to the non-indigenous population [5,6,7]
Body mass index (BMI), SBP and fasting glucose were higher and gamma-glutamyl transferase (GGT) and triglycerides were lower in Torres Strait Islanders (TSI) when compared with Aboriginal people

Summary

Introduction

The interaction between overweight/obesity and alcohol intake on liver enzyme concentrations have been demonstrated. No studies have yet examined the interaction between metabolic syndrome or multiple metabolic risk factors and alcohol intake on liver enzymes. The aim of this study was to examine if alcohol consumption modifies the effect of metabolic risk on elevated serum GGT in Indigenous Australians. The increasing prevalence of obesity, type 2 diabetes, and metabolic syndrome may be important drivers of increasing rates of NAFLD diagnoses [1]. An elevated serum gamma-glutamyl transferase (GGT) has been demonstrated as a biomarker of NAFLD [2] and, it is not the only marker of chronic liver disease, it does predict future diabetes, coronary heart disease and stroke [3,4]. The Australian indigenous population has an excess of metabolic syndrome and type 2 diabetes relative to the non-indigenous population [5,6,7]. Diabetes and CVD account for 7% and 14%, respectively of the overall burden of disease in Indigenous Australians, and for 12% and 24% respectively, of the health gap between indigenous and nonindigenous Australians [10]

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