Background
Methods
Subjects
Clinical and biochemical assessment
Measurement of baPWV
Ultrasonic assessment of carotid artery disease
Statistical analyses
Results
Clinical characteristics of the subjects
GGT (U/L) |
P
| ||||
---|---|---|---|---|---|
Q1 | Q2 | Q3 | Q4 | ||
≤16 | 17–23 | 24–37 | ≥38 | ||
n | 257 | 267 | 250 | 250 | |
Age (years) | 58.6 ± 10.1 | 57.5 ± 10.0 | 55.6 ± 9.5 | 55.1 ± 10.0 | <0.001 |
Male gender (%) | 59 (23.0) | 109 (40.8) | 125 (50.0) | 139 (55.6) | <0.001 |
Current smokers (%) | 25 (9.7) | 37 (13.9) | 47 (18.8) | 49 (19.6) | 0.006 |
Alcohol (%) | 47 (18.3) | 87 (32.6) | 112 (44.8) | 122 (48.8) | <0.001 |
Duration (years) | 9.4 (8.5–10.3) | 8.1 (7.2–9.0) | 6.7 (5.8–7.6) | 6.0 (5.1–6.9) | <0.001 |
BMI (kg/m2) | 23.9 ± 3.1 | 24.7 ± 3.4 | 25.6 ± 3.6 | 26.1 ± 3.6 | <0.001 |
WC (cm) | 83.5 ± 9.1 | 86.1 ± 8.8 | 88.7 ± 8.8 | 90.7 ± 9.6 | <0.001 |
FPG (mg/dL) | 146.3 ± 62.3 | 148.9 ± 56.6 | 161.5 ± 70.0 | 172.1 ± 68.9 | <0.001 |
HbA1c (%) | 7.9 ± 2.1 | 8.0 ± 2.2 | 8.1 ± 2.2 | 8.2 ± 2.0 | 0.345 |
HOMA-IRa
| 3.9 (2.6–5.2) | 2.8 (1.6–4.1) | 3.8 (2.6–5.1) | 4.4 (3.2–5.6) | 0.353 |
TC (mg/dL) | 169.4 ± 44.6 | 173.1 ± 40.8 | 177.7 ± 43.7 | 185.6 ± 48.6 | <0.001 |
TG (mg/dL) | 127.1 (114.6–139.7) | 148.8 (136.3–161.2) | 170.3 (157.2–183.5) | 199.0 (185.9–212.0) | <0.001 |
HDL-C (mg/dL) | 48.1 ± 11.4 | 46.6 ± 12.1 | 46.0 ± 11.9 | 45.6 ± 11.5 | 0.111 |
LDL-C (mg/dL) | 106.5 ± 33.4 | 105.2 ± 34.5 | 110.8 ± 32.7 | 117.3 ± 37.6 | <0.001 |
Uric acid (mg/dL) | 4.8 ± 1.3 | 4.9 ± 1.4 | 5.2 ± 1.5 | 5.3 ± 1.5 | 0.007 |
AST (U/L) | 20.6 ± 5.7 | 22.6 ± 7.4 | 25.3 ± 9.6 | 31.1 ± 13.5 | <0.001 |
ALT (U/L) | 17.8 ± 8.0 | 22.9 ± 12.2 | 28.2 ± 14.3 | 36.3 ± 18.5 | <0.001 |
eGFR (mL/min/1.73 m2) | 101.8 ± 32.4 | 99.0 ± 28.2 | 101.2 ± 27.4 | 106.9 ± 29.5 | 0.021 |
SBP (mmHg) | 129.6 ± 19.3 | 129.4 ± 17.0 | 129.1 ± 16.8 | 132.4 ± 16.9 | 0.264 |
DBP (mmHg) | 76.5 ± 10.5 | 77.7 ± 10.1 | 78.7 ± 9.4 | 80.3 ± 10.3 | <0.001 |
Usage of medication (%)
| |||||
Insulin | 72 (28.0) | 59 (22.1) | 53 (21.2) | 38 (17.1) | 0.006 |
Anti-platelet agent | 101 (39.3) | 100 (37.5) | 83 (33.2) | 80 (32.0) | 0.264 |
CCB | 53 (20.6) | 59 (22.1) | 59 (23.6) | 46 (18.4) | 0.529 |
ACEI/ARB | 93 (36.2) | 84 (61.5) | 95 (38.0) | 85 (34.0) | 0.436 |
Beta blocker | 23 (9.0) | 19 (7.1) | 22 (8.8) | 20 (8.0) | 0.864 |
Statin | 92 (35.8) | 104 (39.0) | 117 (46.8) | 89 (35.6) | 0.034 |
baPWV (cm/s) | 1583 ± 338 | 1578 ± 329 | 1518 ± 322 | 1556 ± 323 | 0.102 |
IMT (mm) | 0.65 ± 0.14 | 0.65 ± 0.14 | 0.67 ± 0.15 | 0.66 ± 0.14 | 0.663 |
Carotid plaque (%)
| 0.984 | ||||
Grade 0 | 161 (62.7) | 168 (62.9) | 156 (62.4) | 150 (60.0) | |
Grade 1 | 23 (9.0) | 22 (8.2) | 16 (6.4) | 22 (8.8) | |
Grade 2 | 46 (17.9) | 46 (17.2) | 44 (17.6) | 51 (20.4) | |
Grade 3 | 25 (9.7) | 29 (10.9) | 32 (12.8) | 26 (10.4) | |
Grade 4 | 2 (0.8) | 2 (0.8) | 2 (0.8) | 1 (0.4) |
Association between GGT level and MetS
Men |
P
| Women |
P
| |
---|---|---|---|---|
mean (95 % CI) | mean (95 % CI) | |||
Elevated BP
| ||||
No | 31.8 (28.7–34.8) | 0.157 | 27.0 (24.5–29.6) | 0.424 |
Yes | 34.5 (32.3–36.6) | 25.8 (24.1–27.5) | ||
Increased WC
| ||||
No | 31.5 (29.2–33.8) | 0.007 | 21.7 (18.9–24.6) | <0.001 |
Yes | 36.4 (33.7–39.1) | 27.6 (26.0–29.2) | ||
High TG
| ||||
No | 29.7 (27.4–32.0) | <0.001 | 23.4 (21.7–25.2) | <0.001 |
Yes | 38.6 (35.9–41.1) | 30.7 (28.5–33.0) | ||
Low HDL-C
| ||||
No | 34.8 (32.5–37.0) | 0.099 | 24.6 (22.4–26.9) | 0.086 |
Yes | 31.7 (28.9–34.5) | 27.2 (25.4–29.0) | ||
MetS
| ||||
No | 30.1 (27.2–32.9) | 0.002 | 21.8 (18.6–25.1) | 0.003 |
Yes | 35.7 (33.5–37.9) | 27.2 (25.6–28.8) | ||
MetS No
| ||||
0 | 29.1 (24.2–34.0) | 0.035 | 17.6 (10.0–25.2) | 0.001 |
1 | 30.6 (27.1–34.1) | 22.7 (19.2–26.3) | ||
2 | 34.8 (31.5–38.1) | 24.8 (22.2–27.3) | ||
3 | 36.0 (32.4–39.5) | 27.5 (25.2–29.8) | ||
4 | 37.8 (32.1–43.5) | 31.4 (27.7–35.0) |
Association between GGT level and high baPWV, carotid atherosclerosis, and carotid stenosis
High baPWVa
| Carotid atherosclerosisb
| Carotid stenosisc
| ||||
---|---|---|---|---|---|---|
OR (95 % CI) |
P
| OR (95 % CI) |
P
| OR (95 % CI) |
P
| |
Non-adjusted
| ||||||
Per GGT (U) | 1.01 (0.99–1.01) | 0.718 | 1.00 (0.99–1.01) | 0.824 | 1.00 (0.99–1.01) | 0.581 |
Q1 | 1 | 1 | 1 | |||
Q2 | 1.24 (0.85–1.81) | 0.258 | 0.84 (0.59–1.18) | 0.316 | 1.12 (0.65–1.93) | 0.687 |
Q3 | 1.10 (0.75–1.62) | 0.634 | 1.00 (0.71–1.42) | 0.983 | 1.34 (0.78–2.30) | 0.285 |
Q4 | 1.13 (0.75–1.69) | 0.565 | 0.97 (0.69–1.38) | 0.874 | 1.03 (0.59–1.81) | 0.915 |
Age and sex-adjusted
| ||||||
Per GGT (U) | 1.00 (0.99–1.01) | 0.980 | 1.00 (0.995–1.01) | 0.584 | 1.00 (0.99–1.01) | 0.793 |
Q1 | 1 | 1 | 1 | |||
Q2 | 1.11 (0.71–1.71) | 0.652 | 0.77 (0.53–1.13) | 0.178 | 1.12 (0.64–1.98) | 0.689 |
Q3 | 0.78 (0.49–1.26) | 0.314 | 1.03 (0.70–1.52) | 0.871 | 1.51 (0.85–2.67) | 0.161 |
Q4 | 1.03 (0.65–1.64) | 0.899 | 0.99 (0.67–1.47) | 0.962 | 1.14 (0.63–2.08) | 0.666 |
Multivariate-adjusted
| ||||||
Per GGT (U) | 1.00 (0.99–1.01) | 0.988 | 1.00 (0.99–1.01) | 0.911 | 1.00 (0.98–1.01) | 0.394 |
Q1 | 1 | 1 | 1 | |||
Q2 | 1.29 (0.80–2.08) | 0.304 | 0.78 (0.53–1.16) | 0.222 | 1.10 (0.62–1.97) | 0.747 |
Q3 | 0.89 (0.53–1.52) | 0.679 | 1.01 (0.67–1.53) | 0.956 | 1.52 (0.78–2.58) | 0.252 |
Q4 | 1.07 (0.63–1.82) | 0.801 | 0.91 (0.60–1.39) | 0.674 | 0.97 (0.51–1.84) | 0.927 |
baPWV | Carotid IMT | Plaque grade | ||||
---|---|---|---|---|---|---|
β
a
|
P
|
β
|
P
|
β
|
P
| |
Model 1
| ||||||
Age | 0.44 | <0.001 | 0.46 | <0.001 | 0.31 | <0.001 |
Male gender | −0.05 | 0.119 | 0.23 | <0.001 | 0.19 | <0.001 |
Diabetic duration | 0.13 | <0.001 | −0.01 | 0.727 | 0.03 | 0.416 |
HbA1c | 0.05 | 0.045 | 0.07 | 0.015 | 0.04 | 0.214 |
Elevated BP | 0.23 | <0.001 | 0.07 | 0.009 | 0.09 | 0.003 |
Increased WC | −0.03 | 0.257 | 0.04 | 0.183 | 0.02 | 0.448 |
High TG | 0.03 | 0.291 | 0.02 | 0.483 | 0.05 | 0.105 |
Low HDL-C | −0.02 | 0.376 | 0.05 | 0.059 | −0.04 | 0.190 |
GGT | 0.05 | 0.084 | 0.02 | 0.540 | −0.003 | 0.923 |
R2
| 39.4 | 25.1 | 12.7 | |||
Model 2
| ||||||
Age | 0.47 | <0.001 | 0.46 | <0.001 | 0.32 | <0.001 |
Male gender | −0.01 | 0.756 | 0.23 | <0.001 | 0.21 | <0.001 |
Diabetic duration | 0.15 | <0.001 | −0.01 | 0.805 | 0.03 | 0.326 |
HbA1c | 0.04 | 0.096 |
0.07
| 0.011 | 0.04 | 0.255 |
MetS No. |
0.11
| <0.001 | 0.11 | <0.001 | 0.07 | 0.027 |
GGT | 0.04 | 0.154 | 0.01 | 0.657 | 0.003 | 0.935 |
R2
| 35.2 | 25.0 | 11.8 |