World J Gastroenterol. 2025;31(40):110932.

Serum gamma-glutamyl transferase level is associated with the risk of pancreatic cystic neoplasms: A nationwide retrospective cohort study.

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제1저자 이민우, 박진명 · 교신저자 한경도, 이상협

PMID 41180989 PMC12576596 DOI 10.3748/wjg.v31.i40.110932 IF 7.7 소화기내과

소속 (5)

Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, South Korea.
Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon 24289, South Korea.
Department of Internal Medicine, Soon Chun Hyang University Hospital, Seoul 04401, South Korea.
Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, South Korea.
Department of Internal Medicine and Liver Research Institute, Seoul National University Hospital, Seoul National University College of Medicine, Seoul 03080, South Korea. gidoctor@snu.ac.kr.

Abstract

BACKGROUND Gamma-glutamyl transferase (GGT) is a known surrogate marker of hepatic dysfunction and oxidative stress. It has recently been reported to be associated with metabolic diseases, cardiovascular diseases, and malignancies including pancreatic cancer. However, data on its association with pancreatic cystic neoplasm (PCN), is unknown.

AIM To investigate the association of GGT with the incidence of PCN.

METHODS In this nationwide retrospective cohort study, participants who received general health checkup by National Health Insurance Service in 2009 were included. Newly diagnosed PCNs from one year after the checkup to 2020 were identified. Participants were divided into quartiles based on GGT levels. Multivariable cox proportional hazard models estimated the risk of PCNs according to GGT quartiles (Q1-Q4). Subgroup analyses by age, sex, and comorbidities, and sensitivity analyses varying lag periods and GGT categorizations were performed.

RESULTS There were 28940 cases of PCNs among 2655665 eligible participants. The incidence rate was 1.09 cases per 1000 person-years, with a median follow-up of 10.32 (interquartile range: 10.09-10.58) years. In multivariate regression analysis, adjusted hazard ratios for GGT quartiles using Q1 group as a reference were: 1.04 [95% confidence interval (CI): 1.005-1.075] for Q2, 1.065 (95%CI: 1.03-1.102) for Q3, and 1.109 (95%CI: 1.07-1.15) for Q4. Subgroup analysis showed consistent results across age, sex, and comorbidities. In sensitivity analyses, the association remained robust even at 3-year and 5-year lag periods. A clear dose-response relationship was also observed when using GGT deciles (All P for trend < 0.001).

CONCLUSION Higher GGT level is associated with increased risk of PCNs. Therefore, serum GGT levels might have a role as a biomarker for the development of PCNs.

Keywords

BiomarkerCohort studyEpidemiologyGamma-glutamyl transferasePancreatic cystic neoplasm

Figures

**Figure 1** **Study population.** Participants underwent general health checkups in 2009 (index period), and a one-year lag period was applied. The follow-up period was until December 31, 2020. Among the 2896383 participants aged 40 years or older, those with a history of pancreatitis or pseudocyst (n = 64763), or a previous diagnosis of pancreatic cystic neoplasm (n = 4298), those with missing data (n = 160987), or those who were diagnosed with pancreatic cystic neoplasm or died within the one-year lag period (n = 10670) were excluded. The final study population consisted of 2655665 individuals, of whom 28940 developed pancreatic cystic neoplasm during the follow-up period.

**Figure 2** **Incidence probability of pancreatic cystic neoplasm stratified by gamma-glutamyl transferase level.** The incidence rate of pancreatic cystic neoplasm was highest in the Q4 group and lowest in the Q1 group. This order remained consistent throughout the observation period (log-rank test P < 0.001).

그림 출처: PubMed Central 공개 논문 (PMC12576596)

Conflict of interest statement

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

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