γ-Glutamyltransferase, but not markers of hepatic fibrosis, is associated with cardiovascular disease in older people with type 2 diabetes mellitus: the Edinburgh Type 2 Diabetes Study

Morling, Joanne R.; Fallowfield, Jonathan A.; Williamson, Rachel M.; Robertson, Christine M.; Glancy, Stephen; Guha, Indra Neil; Strachan, Mark W.J.; Price, Jackie F.

Abstract

© 2015, The Author(s). Aims/hypothesis: We examined the association of prevalent and incident cardiovascular disease (CVD) with chronic liver disease in a cohort of community-based people with type 2 diabetes, in order to clarify the relationship between these two important conditions. Methods: 1,066 participants with type 2 diabetes aged 60–75 years underwent assessment of a range of liver injury markers (non-specific injury, steatosis, steatohepatitis, fibrosis, portal hypertension). Individuals were followed up for incident cardiovascular events. Results: At baseline there were 370/1,033 patients with prevalent CVD, including 317/1,033 with coronary artery disease (CAD). After a mean follow-up of 4.4years there were 44/663 incident CVD events, including 27/663 CAD events. There were 30/82 CVD-related deaths. Risk of dying from or developing CVD was no higher in participants with steatosis than in those without (HR 0.90; 95% CI 0.40, 2.00; p > 0.05). The only notable relationship was with γ-glutamyltransferase (GGT) (incident CVD: adjusted HR for doubling GGT 1.24 [95% CI 0.97, 1.59] p = 0.086; incident CAD: adjusted HR 1.33 [95% CI 1.00, 1.78] p = 0.053), suggesting that in our study population, chronic liver disease may have little effect on the development of, or mortality from, CVD. Conclusions/interpretation: An independent association between GGT and CVD warrants further exploration as a potentially useful addition to current cardiovascular risk prediction models in diabetes. However, overall findings failed to suggest that there is a clinical or pathophysiological association between chronic liver disease and CVD in elderly people with type 2 diabetes.

Citation

Morling, J. R., Fallowfield, J. A., Williamson, R. M., Robertson, C. M., Glancy, S., Guha, I. N., …Price, J. F. (2015). γ-Glutamyltransferase, but not markers of hepatic fibrosis, is associated with cardiovascular disease in older people with type 2 diabetes mellitus: the Edinburgh Type 2 Diabetes Study. Diabetologia, 58(7), 1484-1493. https://doi.org/10.1007/s00125-015-3575-y

• Journal Article Type: Article
• Acceptance Date: Mar 4, 2015
• Online Publication Date: Mar 29, 2015
• Publication Date: 2015-07
• Deposit Date: Apr 27, 2018
• Publicly Available Date: Apr 27, 2018
• Journal: Diabetologia
• Print ISSN: 0012-186X
• Electronic ISSN: 1432-0428
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 58
• Issue: 7
• Pages: 1484-1493
• DOI: https://doi.org/10.1007/s00125-015-3575-y
• Keywords: Cardiovascular diseases; Community-based; Epidemiology; Fatty liver ; γ-Glutamyltransferase ; Type 2 diabetes mellitus
• Public URL: https://nottingham-repository.worktribe.com/output/755907
• Publisher URL: https://link.springer.com/article/10.1007%2Fs00125-015-3575-y
• Related Public URLs: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4473275/
• Contract Date: Apr 27, 2018