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-Glutamyltransferase Activity and Development of the Metabolic Syndrome (International Diabetes Federation Definition) in Middle-Aged Men and Women

Data From the Epidemiological Study on the Insulin Resistance Syndrome (DESIR) cohort

¹ Institut National de la Santé et de la Recherche Médicale (INSERM) Unité 780-IFR69, Epidemiological and Biostatistical Research, Villejuif, France
² Université Paris-Sud, Villejuif, France
³ Institut Inter Régional pour la Santé, La Riche, France

Address correspondence and reprint requests to Philippe André, MD, INSERM U780-IFR69, 16 Avenue Paul Vaillant-Couturier, F-94807, Villejuif Cedex, France. E-mail: andre{at}vjf.inserm.fr

OBJECTIVE—Among hepatic enzymes, -glutamyltransferase (GGT) is the main predictor of type 2 diabetes incidence, although it has not been shown that GGT predicts pre-diabetes states. Our aim was to study the association of GGT with the development of the metabolic syndrome (MetS).

RESEARCH DESIGN AND METHODS—We analyzed the 3-year data from the Data from Epidemiological Study on the Insulin Resistance Syndrome prospective cohort of 1,656 men and 1,889 women without MetS at baseline, according to the International Diabetes Federation definition.

RESULTS—Over 3 years, 309 participants developed the MetS. After adjustment for age, alcohol intake, physical activity, smoking habits, and alanine aminotransferase (ALT), the odds ratios for incident MetS increased across baseline GGT quartiles (1, 1.96, 2.25, and 3.81 in men, P < 0.03; and 1, 1.23, 1.80, and 1.58 in women, P < 0.05). After additional adjustment for insulin resistance markers (fasting insulin or homeostasis model assessment of insulin resistance index), the association was attenuated and the linear relation no longer significant in both sexes (P = 0.08, P = 0.16). However, men in the highest in comparison to the lowest quartile of GGT retained a significant risk for incident MetS. In women, there was no longer a significant risk. GGT was significantly associated with the 3-year incidence of individual components of the MetS. The incidence of the MetS also increased with ALT, but after adjustment on GGT this association remained significant only in women.

CONCLUSIONS—GGT, a predictor of type 2 diabetes, was associated with a risk of incident MetS. This association was mainly related with insulin resistance but was independent of other confounding factors.

Abbreviations: ALT, alanine aminotransferase • AST, aspartate aminotransferase • DESIR, Data From Epidemiological Study on the Insulin Resistance Syndrome • FPG, fasting plasma glucose • GGT, -glutamyltransferase • IDF, International Diabetes Federation • IFG, impaired fasting glucose • HOMA-IR, homeostasis model assessment of insulin resistance • MetS, metabolic syndrome

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