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Abstract

Title: Prospective study of the association of gamma-glutamyltransferase with cancer incidence in women.
Author: Strasak AM,Pfeiffer RM,Klenk J,Hilbe W,Oberaigner W,Gregory M,Concin H,Diem G,Pfeiffer KP,Ruttmann E,Ulmer H,the VHM&PP Study Group VHM&PP Study Group members: Guntram Hinteregger, Karin Parschalk, Wolfgang Metzler, Elmar Stimpfl, Agency for Preventive and Social Medicine, Bregenz, Austria; Kilian Rapp, Stephan K. Weiland, Institute of Epidemiology, Ulm University, Germany.
Journal: International journal of cancer. Journal international du cancer 123(8):1902-1906
Year: 2008
Month: August

Abstract: Although several epidemiologic studies have shown that gamma-glutamyltransferase (GGT) is associated with cardiovascular disease and all-cause mortality, its relationship with cancer incidence remains widely unexplored. In experimental models the ability of cellular GGT to modulate crucial redox-sensitive functions has been established, and it may thus play a role in tumor progression. In the present study, we investigated the association of GGT with overall and site-specific cancer incidence in a population-based cohort of 92,843 Austrian women with 349,674 serial GGT measurements, prospectively followed-up for a median of 13.5 years. The relationship between GGT and cancer incidence was analyzed using adjusted Cox regression models with age as underlying time metric with age as underlying time metric including GGT concentrations at baseline and incorporating repeated GGT measurements as a time-dependent variable. During follow-up, 4,884 incidence cancers were observed. Compared to normal low GGT (<17.99 U/L), cancer risk was elevated for all other GGT categories (p for trend < 0.0001), with adjusted hazard ratios (95% confidence intervals) of 1.06 (0.99-1.13) for GGT levels between 18.00 and 35.99 U/L (normal high), 1.12 (1.02-1.22) for GGT levels between 36.00 and 71.99 U/L (elevated) and 1.43 (1.28-1.61) for highly elevated GGT (>72.00 U/L). Very similar results were seen when GGT was analyzed as a time-dependent variable. In cancer-site specific models, elevated GGT statistically significantly increased the risk for malignant neoplasms of digestive organs, the respiratory system/intrathoracic organs, breast and female genital organs and lymphoid and haematopoietic cancers (all, p < 0.006). Our study is the first to demonstrate in a large population-based cohort that high GGT levels significantly increased cancer risk in women. Published 2008 Wiley-Liss, Inc.