Gamma glutamyl transferase and metabolic syndrome, cardiovascular disease, and mortality risk: The Framingham Heart Study

Douglas S. Lee, Jane C. Evans, Sander J. Robins, Peter W. Wilson, Irene Albano, Caroline S. Fox, Thomas J. Wang, Emelia J. Benjamin, Ralph B. D'Agostino, Ramachandran S. Vasan

Research output: Contribution to journalArticlepeer-review

448 Scopus citations


OBJECTIVE - To determine whether serum γ-glutamyl transferase (GGT) predicts cardiovascular disease (CVD) morbidity and mortality, accounting for temporal changes in known CVD risk factors and C-reactive protein (CRP). METHODS AND RESULTS - In 3451 Framingham Study participants (mean age 44 years, 52% women) we examined the relations of GGT with CVD risk factors, and prospectively determined the risk of new-onset metabolic syndrome, incident CVD, and death. GGT was positively associated with body mass index, blood pressure, LDL cholesterol, triglycerides, and blood glucose in cross-sectional analysis (P<0.005). On follow-up (mean 19 years), 968 participants developed metabolic syndrome, 535 developed incident CVD, and 362 died. The risk of metabolic syndrome increased with higher GGT (multivariable-adjusted hazard ratio [HR] per SD increment log-GGT, 1.26 [95%CI; 1.18 to 1.35]). Adjusting for established CVD risk factors (as time-dependent covariates updated quadriennially) and baseline CRP, a 1-SD increase in log-GGT conferred a 13% increase in CVD risk (P=0.007) and 26% increased risk of death (P<0.001). Individuals in the highest GGT quartile experienced a 67% increase in CVD incidence (multivariable-adjusted HR 1.67, 95%CI; 1.25 to 2.22). CONCLUSION - An increase in serum GGT predicts onset of metabolic syndrome, incident CVD, and death suggesting that GGT is a marker of metabolic and cardiovascular risk.

Original languageEnglish (US)
Pages (from-to)127-133
Number of pages7
JournalArteriosclerosis, thrombosis, and vascular biology
Issue number1
StatePublished - Jan 2007
Externally publishedYes


  • Biomarkers
  • Cardiovascular disease
  • Gamma glutamyl transferase
  • Metabolic syndrome
  • Mortality
  • Risk factor

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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