Correlation Analysis Of Serum Glutamyltranspeptidase And Hyperuricemia In Physical Examination Population

ObjectiveTo explore and analyze the relationship between gamma-glutamyltransferase(GGT)and Hyperuricemia(HUA)from different perspectives,and to provide a new idea for the identification of high-risk groups of HUA and the prevention and treatment of HUA.Materials and Methods1.Cross-sectional studyPeople who met the inclusion and exclusion criteria in the physical examination center database of a Grade A hospital in Dalian from January 2016 to December 2016 were selected as the research subjects.Every research object based information collection(age,sex,past history and medication history,etc.),physical examination(height,weight,abdominal circumference,blood pressure,body mass index(BMI)),abdominal ultrasound results and laboratory screening index(blood uric acid(SUA),creatinine(Cr),alanine aminotransferase(ALT),aspartate aminotransferase(AST),gamma-glutamyltransferase(GGT),fasting plasma glucose(FPG),triglycerides(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),total protein(TP),albumin(Alb),white blood cells(WBC),red blood cell(RBC),hemoglobin(HGB),platelet(PLT)),etc.The subjects were divided into HUA group and non-HUA group according to their uric acid level,and the differences in general data between the two groups were compared.The subjects were divided into Q1-Q4 groups according to the quartile of GGT level,and the differences in the prevalence of HUA among people with different GGT levels were analyzed,as well as the incidence of hypertension,diabetes,overweight or obesity,dyslipidemia and fatty liver with the increase of GGT level.Logistic regression analysis was used to compare the correlation between different GGT levels and HUA.2.Retrospective Cohort studyA retrospective cohort study was conducted on the non-HUA patients in cross section who met the inclusion and exclusion criteria.The basic information,physical examination and laboratory test indicators of each study subject from 2016 to 2018 were collected retrospectively.All subjects were followed up for ≥1 time,and the end point of follow-up was the occurrence of HUA or the absence of HUA at the end of follow-up.According to baseline GGT level,GGT was divided into Q1-Q4 groups according to quartile method,and general baseline data were compared between each group.The cumulative incidence of HUA among the four groups with GGT level Q1-Q4 was compared.Cox proportional risk model was used to analyze the risk of HUA among GGT groups with different levels.Results1.Cross-sectional study1.1A total of 6,211 subjects(4,281 males and 1,930 females)were included in this study.Statistics showed that the overall prevalence of HUA in Dalian area was higher(27.69%),and the prevalence of HUA in males(35.67%)was significantly higher than that in females(10%).The prevalence of HUA showed a significant linear trend with the increase of age(P<0.001)and tended to be younger.The serum uric acid level of male((396.56±82.59)μmol/L)was significantly higher than that of female((278.03±60.98)μmol/L)(P<0.05).1.2 In the physical examination group,there were more males in the HUA group.BMI,waist circumference,FPG,TC,TG,LDL-C,ALT,AST,GGT,TP,Alb,TB,SUA,Cr,BUN,WBC,RBC and HGB were significantly higher than those in the non-HUA group,while age and HDL-C were lower than those in the non-HUA group(P<0.05).1.3The GGT level was divided into four groups according to quartile: Q1: GGT<13,Q2:13 ≤GGT<20,Q3:20≤GGT<33,Q4:GGT≥33.The results showed that with the increase of GGT level,the prevalence of HUA increased gradually,and the prevalence of hypertension,diabetes,dyslipid9 emia,overweight or obesity,and fatty liver also increased gradually(trend test,P<0.001).1.4 Logistic regression analysis showed that after adjusting for gender,age,FPG,TC,TG,DBP,SBP,ALT,AST,WBC and other indicators,the elevated GGT level was a risk factor for HUA.2.Retrospective Cohort study2.1 A total of 2116 persons meeting the criteria were included in this study.Baseline was divided into 4 groups according to the quartile of GGT level,Q1: GGT<12,Q2:12≤GGT<17,Q3:17≤GGT<28 Q4: GGT≥28.The results showed that with the increase of GGT level,age,waist circumference,BMI,SBP,DBP,FPG,TC,TG,LDL-C,SUA,CR,ALT,AST,WBC,RBC,HGB increased(P<0.05),HDL-C and PLT decreased(trend test,P<0.05).2.2 In the follow-up population,the cumulative incidence of HUA was 27.4%,and the cumulative incidence of HUA in Q1,Q2,Q3,and Q4 groups was 13.17%,23.03%,30.7%,and 40.97%,respectively.The results showed that with the increase of GGT level,the probability of newly developing HUA increased significantly(trend test,P<0.001).2.3 Cox regression analysis showed that the risk of HUA in Q2,Q3 and Q4 groups was 1.616(1.226,2.129)times,2.324(1.796,3.006)times and 3.23(2.527,4.128)times of that in Q1 group without adjusting for any factors,taking Q1 as the reference group.After adjusting for gender and age,the risk of HUA in Q2,Q3 and Q4 groups was1.353(1.014,1.806)times,1.73(1.298,2.307)times and 2.278(1.713,3.028)times of that in Q1 group,respectively.After adjusting for confounders such as BMI,waist circumference,FPG,blood lipid,SBP,DBP,ALT,AST,GGT,Cr and WBC,the risk of HUA in Q2,Q3 and Q4 groups was 1.213(0.905,1.626)times,1.376(1.018,1.859)times and 1.644(1.19,2.271)times,respectively,compared with that in Q1 group.ConclusionWith the increase of baseline serum GGT level,the disease and risk of HUA increased gradually,and serum GGT was an independent risk factor for the development of HUA.Regular monitoring of serum GGT index changes in the physical examination population is of great significance to prevent the occurrence of HUA.