Abstract
BackgroundNonalcoholic 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.MethodsWe 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.ResultsThe 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.ConclusionsThe 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.
Highlights
Nonalcoholic fatty liver disease is characterized by excessive hepatic fat accumulation
Consecutive elevated gamma-glutamyl transferase (GGT) levels increase the risk for fatty liver, and high TG levels in those individuals further independently increase the risk
Fatty liver changes are an important sign of Nonalcoholic fatty liver disease (NAFLD), which covers a spectrum of liver diseases ranging from benign simple steatosis/nonalcoholic fatty liver (NAFL) to hepatic inflammation and fibrosis/nonalcoholic steatohepatitis (NASH) that can lead to cirrhosis and hepatocellular carcinoma [3, 4]
Summary
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. 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. Nonalcoholic fatty liver disease (NAFLD) is characterized by excessive hepatic fat accumulation as detected by imaging or histology after appropriate exclusion of other liver diseases such as alcoholic liver disease. NAFLD can be detected because almost all CMCs include abdominal ultrasonography and liver function tests. CMCs data have shown that 9–30% of Japanese adults have ultrasonography diagnosed NAFLD [4]
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