Correlation Between Serum Gamma-glutamyl Transferase Level And Acute Coronary Syndrome In Elderly Diabetics

1Background and objectiveDiabetes mellitus type2is one of the risk factors of cardiovascular diseases, andthe incidence of coronary heart disease is apparently increasing in diabatic patients,so is the incidence of composite endpoint events, such as the cardiac mortality,nonfatal myocardial infarction and severe heart failure. γ-glutamyl transferase(GGT) is an enzymatic liver function test available for several decades, initially usedas a sensitive indicator of alcohol ingestion. Recent studies suggested that elevatedGGT level is independently correlated with conditions associated with increasedatherosclerosis, such as obesity, elevated serum cholesterol, high blood pressure andmyocardial infarction. It is demonstrated that serum GGT activity is an independentrisk factor for myocardial infarction and cardiac death in patientswith coronary arterydisease. This research mainly explores the correlation between serum γ-glutamyltransferase（GGT）level and acute coronary syndrome（ACS）in elderly diabetics.2Study Object and Methods2.1Study objectFrom Septem ber2012to March2013, a total of92senile diabetic patients withacute coronary syndrome (DA group),103T2DM patients (DM group) and96ACSpatients (ACS group) admitted to the Department of Geriatrics and Endocrinology of the First Affiliated Hospital of Zhengzhou University were recruited into our study.81healthy elderly were included as NC group.2.2MethodsThe biochemical parameters and anthropometric indices were determined usingstandard procedures. The comparisons of serum GGT and incidence of ACS amonggroup were carried out for observation.2.3Statistical processingAll calculations were performed with SPSS version17.0software. All data weretested for normal distribution with the Kolmogorov–Smirnov test. Statisticalcomparisons by angiographic and echocardiographic parameters were done only inpatient groups. Whether a significant difference was present or not in terms ofvariables between groups was evaluated by One-Way ANOVA. Scheffe test was usedfor paired comparisons. Chi-square test was used to compare nominal variables.Correlations between GGT and other index were evaluated by Pearson’s correlationcoefficient. The influence from GGT to ACS in T2DM patients is evaluated byLogistic regression analysis. An adjusted value of P<0.05was considered to bestatistically significant.3Results3.1Comparison of general data and biochemical indexes in the fourgroupsThe BMI and serum GGT in DA group were higher than NC group, DM groupand ACSgroup(P<0.05). The TC and TG in DA group were both higher than the NCgroup while the HDL-C was lower than the NC group(P<0.05). 3.2Pearson correlation analysis on GGT and each indexPearson correlation analysis showed that the serum GGT was positivelycorrelated with TG and LDL-C (r=0.657,0.742, P<0.05).3.3The level of serum GGT with different risk of ACS in T2DMpatientsThe patients in DA group an DM group were divided into GGT≤17.4U/L(49cases),17.5-25.3U/L(49cases),25.4-42.7U/L(49cases), GGT>42.7U/L(48cases).Logistic regression analysis was conducted by using GGT≤17.4U/L group as thecontrol group. The results showed that the OR for ACS in17.5-25.3U/L,25.4-42.7U/L and GGT>42.7U/L group was1.41,2.03and2.23, respectively. Afteradjusting BMI and HbA1c, the OR of serum GGT in predicting ACS was1.784[95%CI (1.146,2.778), P=0.010]. After further adjusting the TG and LDL-C, the OR ofserum GGT in predicting ACS in elderly with T2DM was1.690[95%CI(1.023,2.794), P=0.041].4ConclusionThe increase of GGT level maybe a independent and significant risk factor ofACS among elder diabetics. It is necessary to monitor the GGT level in order topredict the occurrence of ACS.