Association of Serum Gamma-Glutamyl Transferase Level with Metabolic Syndrome and Insulin Resistance in Adults

Background: MetS is a serious global public health challenge. All the components of MetS are associated with several non-communicable chronic diseases such as T2DM, coronary artery diseases (CAD), cerebrovascular diseases and non-alcoholic fatty liver disease (NAFLD) which are leading cause of death in whole world. Besides these, recent studies have suggested that all components of MetS are independently associated with several cancers. IR is known to play a significant role in the development of MetS.

Materials & Methods: In this study, a total of 110 subjects were selected among them 49 subjects were MetS and 61 were without MetS. Subjects of the study were selected purposively according to the selection criteria from the subjects attending the OPD of Medicine department of SSMC and Mitford Hospital, Dhaka.

Results: Logistic regression analysis showed that after adjustment for age, sex, BMI, ALT, uric acid and LDL-C, the odds ratios (95% CI) for MetS were increased across GGT tertiles (1, 1.22 (0.36-4.12), p=0.738; 5.09 (2.06-12.58), p<0.001). Multiple linear regression analysis showed significant positive association of serum GGT (p<0.001) with HOMA-IR. In model 1, BMI (p<0.05) and TG (p<0.05) showed significant association with HOMA-IR. However, when GGT entered into model 2, the association of TG with HOMA-IR became insignificant and an independent linear association of GGT with HOMA-IR was evident. Insulin, HOMA-IR and all components of MetS except HDL-C are increased in subjects with higher level of GGT.BMI, WC, BP, FPG, insulin, TG and GGT are higher but HDL-C is lower in subjects with MetS and IR as compared to those subjects without MetS and IR. Elevated serum GGT is related with IR and MetS including its components. However, this relationship showed no gender variation. Odds ratios for MetS are increased with increasing tertiles of serum GGT that indicates higher GGT levels are associated with risk for MetS. This association is related with insulin resistance but independent of other confounding factors. Moreover, it is independently associated with insulin resistance.

Conclusion: This study showed that there was strong significant positive correlation of GGT with HOMA-IR and all components of MetS except HDL-C which was negatively correlated with GGT. In either gender, the relationship between serum GGT and the MetS and HOMA-IR components remained substantial.