γ-Glutamyltransferase, but not markers of hepatic fibrosis, is associated with cardiovascular disease in older people with type 2 diabetes mellitus: the Edinburgh Type 2 Diabetes Study

AIMS/HYPOTHESIS: We examined the association of prevalent and incident cardiovascular disease (CVD) with chronic liver disease in a cohort of community-based people with type 2 diabetes, in order to clarify the relationship between these two important conditions. METHODS: 1,066 participants with...

Full description

Bibliographic Details
Main Authors: Morling, Joanne R., Fallowfield, Jonathan A., Williamson, Rachel M., Robertson, Christine M., Glancy, Stephen, Guha, Indra Neil, Strachan, Mark W.J., Price, Jackie F.
Format: Article
Published: Springer 2015
Subjects:
Online Access:https://eprints.nottingham.ac.uk/51432/
_version_ 1848798494693785600
author Morling, Joanne R.
Fallowfield, Jonathan A.
Williamson, Rachel M.
Robertson, Christine M.
Glancy, Stephen
Guha, Indra Neil
Strachan, Mark W.J.
Price, Jackie F.
author_facet Morling, Joanne R.
Fallowfield, Jonathan A.
Williamson, Rachel M.
Robertson, Christine M.
Glancy, Stephen
Guha, Indra Neil
Strachan, Mark W.J.
Price, Jackie F.
author_sort Morling, Joanne R.
building Nottingham Research Data Repository
collection Online Access
description AIMS/HYPOTHESIS: We examined the association of prevalent and incident cardiovascular disease (CVD) with chronic liver disease in a cohort of community-based people with type 2 diabetes, in order to clarify the relationship between these two important conditions. METHODS: 1,066 participants with type 2 diabetes aged 60–75 years underwent assessment of a range of liver injury markers (non-specific injury, steatosis, steatohepatitis, fibrosis, portal hypertension). Individuals were followed up for incident cardiovascular events. RESULTS: At baseline there were 370/1,033 patients with prevalent CVD, including 317/1,033 with coronary artery disease (CAD). After a mean follow-up of 4.4 years there were 44/663 incident CVD events, including 27/663 CAD events. There were 30/82 CVD-related deaths. Risk of dying from or developing CVD was no higher in participants with steatosis than in those without (HR 0.90; 95% CI 0.40, 2.00; p > 0.05). The only notable relationship was with γ-glutamyltransferase (GGT) (incident CVD: adjusted HR for doubling GGT 1.24 [95% CI 0.97, 1.59] p = 0.086; incident CAD: adjusted HR 1.33 [95% CI 1.00, 1.78] p = 0.053), suggesting that in our study population, chronic liver disease may have little effect on the development of, or mortality from, CVD. CONCLUSIONS/INTERPRETATION: An independent association between GGT and CVD warrants further exploration as a potentially useful addition to current cardiovascular risk prediction models in diabetes. However, overall findings failed to suggest that there is a clinical or pathophysiological association between chronic liver disease and CVD in elderly people with type 2 diabetes. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00125-015-3575-y) contains peer-reviewed but unedited supplementary material, which is available to authorised users.
first_indexed 2025-11-14T20:20:40Z
format Article
id nottingham-51432
institution University of Nottingham Malaysia Campus
institution_category Local University
last_indexed 2025-11-14T20:20:40Z
publishDate 2015
publisher Springer
recordtype eprints
repository_type Digital Repository
spelling nottingham-514322020-05-04T17:12:03Z https://eprints.nottingham.ac.uk/51432/ γ-Glutamyltransferase, but not markers of hepatic fibrosis, is associated with cardiovascular disease in older people with type 2 diabetes mellitus: the Edinburgh Type 2 Diabetes Study Morling, Joanne R. Fallowfield, Jonathan A. Williamson, Rachel M. Robertson, Christine M. Glancy, Stephen Guha, Indra Neil Strachan, Mark W.J. Price, Jackie F. AIMS/HYPOTHESIS: We examined the association of prevalent and incident cardiovascular disease (CVD) with chronic liver disease in a cohort of community-based people with type 2 diabetes, in order to clarify the relationship between these two important conditions. METHODS: 1,066 participants with type 2 diabetes aged 60–75 years underwent assessment of a range of liver injury markers (non-specific injury, steatosis, steatohepatitis, fibrosis, portal hypertension). Individuals were followed up for incident cardiovascular events. RESULTS: At baseline there were 370/1,033 patients with prevalent CVD, including 317/1,033 with coronary artery disease (CAD). After a mean follow-up of 4.4 years there were 44/663 incident CVD events, including 27/663 CAD events. There were 30/82 CVD-related deaths. Risk of dying from or developing CVD was no higher in participants with steatosis than in those without (HR 0.90; 95% CI 0.40, 2.00; p > 0.05). The only notable relationship was with γ-glutamyltransferase (GGT) (incident CVD: adjusted HR for doubling GGT 1.24 [95% CI 0.97, 1.59] p = 0.086; incident CAD: adjusted HR 1.33 [95% CI 1.00, 1.78] p = 0.053), suggesting that in our study population, chronic liver disease may have little effect on the development of, or mortality from, CVD. CONCLUSIONS/INTERPRETATION: An independent association between GGT and CVD warrants further exploration as a potentially useful addition to current cardiovascular risk prediction models in diabetes. However, overall findings failed to suggest that there is a clinical or pathophysiological association between chronic liver disease and CVD in elderly people with type 2 diabetes. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00125-015-3575-y) contains peer-reviewed but unedited supplementary material, which is available to authorised users. Springer 2015-07-31 Article PeerReviewed Morling, Joanne R., Fallowfield, Jonathan A., Williamson, Rachel M., Robertson, Christine M., Glancy, Stephen, Guha, Indra Neil, Strachan, Mark W.J. and Price, Jackie F. (2015) γ-Glutamyltransferase, but not markers of hepatic fibrosis, is associated with cardiovascular disease in older people with type 2 diabetes mellitus: the Edinburgh Type 2 Diabetes Study. Diabetologia, 58 (7). pp. 1484-1493. ISSN 1432-0428 Cardiovascular diseases; Community-based; Epidemiology; Fatty liver ; γ-Glutamyltransferase ; Type 2 diabetes mellitus https://link.springer.com/article/10.1007%2Fs00125-015-3575-y doi:10.1007/s00125-015-3575-y doi:10.1007/s00125-015-3575-y
spellingShingle Cardiovascular diseases; Community-based; Epidemiology; Fatty liver ; γ-Glutamyltransferase ; Type 2 diabetes mellitus
Morling, Joanne R.
Fallowfield, Jonathan A.
Williamson, Rachel M.
Robertson, Christine M.
Glancy, Stephen
Guha, Indra Neil
Strachan, Mark W.J.
Price, Jackie F.
γ-Glutamyltransferase, but not markers of hepatic fibrosis, is associated with cardiovascular disease in older people with type 2 diabetes mellitus: the Edinburgh Type 2 Diabetes Study
title γ-Glutamyltransferase, but not markers of hepatic fibrosis, is associated with cardiovascular disease in older people with type 2 diabetes mellitus: the Edinburgh Type 2 Diabetes Study
title_full γ-Glutamyltransferase, but not markers of hepatic fibrosis, is associated with cardiovascular disease in older people with type 2 diabetes mellitus: the Edinburgh Type 2 Diabetes Study
title_fullStr γ-Glutamyltransferase, but not markers of hepatic fibrosis, is associated with cardiovascular disease in older people with type 2 diabetes mellitus: the Edinburgh Type 2 Diabetes Study
title_full_unstemmed γ-Glutamyltransferase, but not markers of hepatic fibrosis, is associated with cardiovascular disease in older people with type 2 diabetes mellitus: the Edinburgh Type 2 Diabetes Study
title_short γ-Glutamyltransferase, but not markers of hepatic fibrosis, is associated with cardiovascular disease in older people with type 2 diabetes mellitus: the Edinburgh Type 2 Diabetes Study
title_sort γ-glutamyltransferase, but not markers of hepatic fibrosis, is associated with cardiovascular disease in older people with type 2 diabetes mellitus: the edinburgh type 2 diabetes study
topic Cardiovascular diseases; Community-based; Epidemiology; Fatty liver ; γ-Glutamyltransferase ; Type 2 diabetes mellitus
url https://eprints.nottingham.ac.uk/51432/
https://eprints.nottingham.ac.uk/51432/
https://eprints.nottingham.ac.uk/51432/