Abstract
The aim of this study is to investigate whether GGT variability is able to predict the risk of end-stage renal disease (ESRD). The study subjects were Koreans who conducted health exams supported by the Korean National Health Insurance Corporation during 2009–2012 (baseline). After excluding individuals aged < 40 years, heavy alcoholics, or those with histories of chronic liver disease or ESRD, we followed 6,058,995 individuals. We calculated the average successive variability (ASV) of GGT values during the 5 years before the baseline as a parameter of variability. Using Cox proportional analyses, we evaluated the risk of ESRD according to GGT ASV quartiles, defined as the initiation of renal replacement therapy or kidney transplantation, or December 31, 2016. During 38,663,279.3 person-years of follow-up, 12,057 cases of ESRD were identified. Compared with GGT ASV quartile 1, the risk of ESRD was higher in ASV quartiles 3–4 and increased serially, even after adjustment for several metabolic parameters, baseline renal function, presence of comorbidities, low income, and baseline GGT and hemoglobin level. The fully adjusted hazard ratios (95% confidence intervals) of GGT ASV quartiles 3 and 4 were 1.06 (1.01–1.12) and 1.12 (1.06–1.18), respectively. In conclusion, GGT variability is a putative risk factor for ESRD in Koreans.
Highlights
The aim of this study is to investigate whether gamma-glutamyl transferase (GGT) variability is able to predict the risk of end-stage renal disease (ESRD)
When study subjects were stratified by baseline GGT quartile, the metabolic variables got worse as the baseline GGT quartile increased (Supplementary Table S1)
According to the baseline GGT quartile, the risk for ESRD was significantly higher in GGT quartile 4 than in quartile 1 after adjusting for age, sex, estimated glomerular filtration rate (eGFR), and body mass index (BMI) (Table 2)
Summary
The aim of this study is to investigate whether GGT variability is able to predict the risk of end-stage renal disease (ESRD). After excluding individuals aged < 40 years, heavy alcoholics, or those with histories of chronic liver disease or ESRD, we followed 6,058,995 individuals. Compared with GGT ASV quartile 1, the risk of ESRD was higher in ASV quartiles 3–4 and increased serially, even after adjustment for several metabolic parameters, baseline renal function, presence of comorbidities, low income, and baseline GGT and hemoglobin level. Several anthropometric and metabolic factors, such as age, being male, obesity, diabetes, hypertension, and dyslipidemia have been demonstrated as risk factors for chronic kidney disease (CKD) in the previous s tudies[4,5]. Previous studies have shown that elevated GGT levels can predict diabetes, hypertension, Scientific Reports | (2020) 10:11668. In the coefficient of variation (CV) of TC, the highest quartile group showed more than twice the risk of ESRD compared with the lowest quartile group
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