Association Between Serum γ-Glutamyltransferase and Acute Ischemic Nonembolic Stroke in Elderly Subjects
Received 13 May 2009; accepted 23 July 2009.
Abstract
Background and Aims
Elevated serum γ-glutamyltransferase (GGT) levels have been proposed as an independent predictor for cardiovascular morbidity and mortality. The aim of this study was to determine whether GGT levels are associated with acute ischemic/nonembolic stroke in a case-control study of elderly subjects.
Methods
A total of 163 patients >70 years of age (88 men) admitted due to a first-ever acute ischemic/nonembolic stroke and 166 volunteers (87 men) without a history of cardiovascular disease were included. The association between GGT and stroke was determined by multivariate logistic regression modelling after adjusting for potential confounding factors.
Results
GGT levels were higher in subjects with metabolic syndrome (MetS) and correlated with MetS individual components including insulin resistance. Stroke patients showed higher concentrations of GGT compared with controls. In univariate analysis, crude odds ratio (OR) for GGT was 1.06/1 IU/L increase (95% CI, 1.03−1.09; p<0.001). Compared to subjects with GGT levels in the lowest quartile, those within the highest quartile had a 4.7-times increase in the odds of experiencing an ischemic stroke (95% CI 2.39-9.11, p<0.001). This association remained significant after controlling for all potential confounders (adjusted OR, 2.90, 95% CI, 1.35−6.27; p=0.007). Analysis of interaction between MetS and GGT showed that subjects with MetS had a 1.08 higher odds/1 IU/L increase in GGT to experience an ischemic stroke [adjusted OR, 1.08 (95% CI, 1.04−1.12; p<0.001).
Conclusions
There are positive associations between serum GGT and first ischemic/nonembolic stroke in individuals >70 years of age independent of established risk factors for cardiovascular disease and concurrent metabolic abnormalities.
aDepartment of Cardiology, Faculty of Medicine, University of Ioannina, Ioannina, Greece
bDepartment of Internal Medicine, Faculty of Medicine, University of Ioannina, Ioannina, Greece
cAcute Stroke Unit, Department of Clinical Therapeutics, Medical School, University of Athens, Athens, Greece
Address reprint requests to: Haralampos J. Milionis, MD, Department of Internal Medicine, Faculty of Medicine, University of Ioannina, 451 10 Ioannina, Greece; Phone: +30 2651097509; FAX: +30 2651097016
ABSTRACT