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The Association Between Gamma-Glutamyl Transferase and Metabolic Syndrome and Its Components Among Adolescents
Farzad Esmaeili1, Siavash Safiee1,2, Mitra Hasheminia1
1Prevention of Metabolic Disorders Research Center, Research Institute for Metabolic and Obesity Disorders, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Introduction:
The prevalence of metabolic syndrome (MetS), a cluster of metabolic abnormalities, is rising globally, particularly in the Middle East and North Africa. Gamma-glutamyl transferase (GGT) is gaining attention as a biomarker for liver function and its association with MetS and its components.
Methods:
This cross-sectional study is part of the Tehran Lipid and Glucose Study (TLGS). We included 696 adolescents (347 males) aged 10-19 from the seventh examination survey (2018-2021). MetS was defined using both the International Diabetes Federation (IDF) and Cook's criteria. Serum GGT was measured, and its association as a continuous and categorical variable was assessed with MetS and its components using logistic regression, adjusting for a large set of covariates.
Results:
MetS prevalence was 15.66% and 9.19% according to Cook's and IDF criteria, respectively. Higher GGT levels were significantly associated with increased MetS risk by both definitions (odds ratio [95% confidence interval] = 1.28 [1.12-1.46] and 1.30 [1.14-1.49] per 5 U/L increase, respectively) after adjusting for age, sex, smoking and family history of type 2 diabetes mellitus. This association was attenuated upon adjusting for ALT levels. GGT levels were robustly associated with high waist circumference, with odds ratios of 1.98 [1.59-2.46] and 1.71 [1.38-2.11] per 5 U/L increase, respectively, even after adjusting for alanine aminotransferase (ALT). Associations with high blood pressure (21% and 17% increased risk by IDF and Cook's criteria) and triglycerides (13% and 16% increased risk by IDF and Cook's criteria) were significant but attenuated after ALT adjustment. No significant associations were found between GGT levels and high fasting plasma glucose or low high-density lipoprotein cholesterol.
Conclusions:
Elevated serum GGT is strongly associated with a higher risk of MetS and its components, particularly central obesity, in adolescents. These findings suggest that GGT is a valuable biomarker for early MetS detection.
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