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American Journal of Epidemiology Advance Access originally published online on November 17, 2005
American Journal of Epidemiology 2006 163(1):57-65; doi:10.1093/aje/kwj006
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American Journal of Epidemiology Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.

Original Contribution

A Strong Secular Trend in Serum Gamma-Glutamyltransferase from 1996 to 2003 among South Korean Men

Duk-Hee Lee1, Myung-Hwa Ha2, Sin Kam1, Byungyeol Chun1, Jangkyu Lee1, Kyungeun Song3, Yongchool Boo4, Lyn Steffen5 and David R. Jacobs, Jr.6

1 Department of Preventive Medicine and Health Promotion Research Center, School of Medicine, Kyungpook National University, Daegu, South Korea
2 Health Care Center, Pohang Iron and Steel Company Ltd., Pohang, South Korea
3 Department of Clinical Pathology, School of Medicine, Kyungpook National University, Daegu, South Korea
4 Department of Molecular Biology, School of Medicine, Kyungpook National University, Daegu, South Korea
5 Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis, MN
6 Department of Nutrition, Faculty of Medicine, University of Oslo, Oslo, Norway

Correspondence to Dr. Duk-Hee Lee, Department of Preventive Medicine, School of Medicine, Kyungpook University, 101 Dongin-dong, Jung-gu, Daegu, South Korea 700-422 (e-mail: lee_dh{at}knu.ac.kr).

Serum gamma-glutamyltransferase (GGT) concentration, within its normal range, has recently been proposed as a reliable marker of oxidative stress. Oxidative stress plays a central pathogenic role in many metabolic and/or cardiovascular diseases, incidences of which have recently increased in South Korea. Since serum GGT has strong associations with these diseases and their risk factors, the authors hypothesized a corresponding secular trend of increasing serum GGT levels in South Korea. Study subjects were 8,072 male workers at a large steel company who were aged 24–44 years at baseline and had received annual physical examinations from 1996 to 2003. The secular trend was a 0.1066-units/liter increase in ln(GGT) level per calendar year (a 180% increase during the 7-year follow-up period) (p < 0.01). Adjustment for body mass index, alcohol consumption, smoking, exercise, and cholesterol level as time-dependent covariates did not change the results. Although cholesterol is commonly used as a marker of epidemiologic transition, there was a less dramatic secular trend in ln(serum cholesterol) level, and it disappeared after adjustment for the secular trend in serum GGT. These findings suggest that serum GGT concentration can be used as a sensitive marker of epidemiologic transition, and they portend a continuing rise in incidences of metabolic and/or cardiovascular diseases in this population in the coming years.

aging; alanine transaminase; cholesterol; gamma-glutamyltransferase; Korea; oxidative stress; time


Abbreviations: ALT, alanine aminotransferase; GGT, gamma-glutamyltransferase


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