A Strong Interaction between Serum γ-Glutamyltransferase and Obesity on the Risk of Prevalent Type 2 Diabetes: Results from the Third National Health and Nutrition Examination Survey
Open Access
- 1 June 2007
- journal article
- Published by Oxford University Press (OUP) in Clinical Chemistry
- Vol. 53 (6), 1092-1098
- https://doi.org/10.1373/clinchem.2006.079814
Abstract
Background: Some studies have found an association of obesity with type 2 diabetes only among individuals with high normal serum γ-glutamyltransferase (GGT) activity, not in those with low serum GGT. If this interaction reflected pathophysiology, it would have scientific and clinical importance. The findings failed to reach statistical significance, however, and no articles have focused on the topic. We investigated possible interactions between serum GGT and body mass index (BMI) and their effects on the risk of prevalent type 2 diabetes and homeostasis model assessment (HOMA) insulin resistance. Methods: We analyzed 4011 adults ≥40 years old who participated in the 3rd US National Health and Nutrition Examination Survey. Results: BMI was associated with prevalent diabetes only among persons with high normal serum GGT activity (P for interaction = 0.002). In the highest serum GGT quartile, adjusted odds ratios for BMI 25–29.9, 30–34.5, and ≥35 kg/m2 compared with BMI<25 kg/m2 were 3.1, 5.1, and 6.2, respectively (P for trend <0.001). In the lowest serum GGT quartile, BMI was not associated with diabetes; corresponding adjusted odds ratios were 1.0, 0.9, 1.8, and 0.8 (P for trend = 0.551). After prevalent diabetes was excluded, there was a parallel interaction with HOMA levels (P for interaction <0.001). Conclusions: BMI was not associated with prevalent type 2 diabetes when GGT was low normal, suggesting that obesity itself may not be a sufficient risk factor for type 2 diabetes. Practically, this interaction can be useful in clinical settings to identify individuals at high risk for type 2 diabetes.Keywords
This publication has 21 references indexed in Scilit:
- Three-year increase of gamma-glutamyltransferase level and development of type 2 diabetes in middle-aged men and women: the D.E.S.I.R. cohortDiabetologia, 2006
- γ-Glutamyltransferase, Obesity, and the Risk of Type 2 Diabetes: Observational Cohort Study among 20,158 Middle-Aged Men and WomenJournal of Clinical Endocrinology & Metabolism, 2004
- γ-Glutamyltransferase Is a Predictor of Incident Diabetes and Hypertension: The Coronary Artery Risk Development in Young Adults (CARDIA) StudyClinical Chemistry, 2003
- Gamma-glutamyltransferase and diabetes—a 4 year follow-up studyDiabetologia, 2003
- Gamma Glutamyl TransferaseCritical Reviews in Clinical Laboratory Sciences, 2001
- Serum Gamma-Glutamyl Transferase, Self-Reported Alcohol Drinking, and the Risk of StrokeStroke, 2000
- Prospective Study of Serum γ-Glutamyltransferase and Risk of NIDDMDiabetes Care, 1998
- Distribution, Determinants, and Prognostic Value of γ-Glutamyltransferase for All-Cause Mortality in a Cohort of Construction Workers from Southern GermanyPreventive Medicine, 1997
- Gamma-glutamyltransferase: Determinants and Association with Mortality from Ischemic Heart Disease and All CausesAmerican Journal of Epidemiology, 1995
- THE TROMSØ STUDYAmerican Journal of Epidemiology, 1990