Association of gamma-glutamyltransferase with incidence of type 2 diabetes in Japan

The aim of this research was to examine the association of gamma-glutamyltransferase (GGT) and its interactions with alcohol consumption (alcohol), body mass index (BM!) and/or alanine aminotransferase (ALT) on the incidence of type 2 diabetes (DM) in Japan. Data from annual health examinations obtained from 1995 to 2005 were analyzed. The total number of subjects in this cohort was 39,563. Hazard ratios (HRs) were calculated by Cox regression analysis. GGT levels were positively associated with the incidence of DM in both men and women, after adjustment for several variables, including alcohol, BMI and ALT. Among women, the association was stronger in non-drinkers than in drinkers due to a significant interaction of GGT and alcohol. In non-drinkers, the HRs of the third and fourth GGT quartiles in women and the fourth GGT quartile in men were significantly higher than those of the first GGT quartile. The association between BMI and the incidence of DM was enhanced by increased GGT levels in women. When GGT levels were in the second to fourth quartiles, the HRs of obese subjects were significantly higher than those of underweight subjects. Conversely, obesity was no longer a significant risk factor for DM when GGT level was in the first quartile. Increased GGT levels were associated with the development of DM after adjustment for several possible confounding factors. The association between GGT and DM in non-drinkers was significantly stronger than that in drinkers. Furthermore, in women, obesity is no longer a risk factor for DM when GGT level is low.