Serum Gamma-glutamyltransferase Levels Predict the Progression of Coronary Artery Calcification in Adults With Type 2 Diabetes Mellitus

Progression of coronary artery calcification (CAC) may be more predictive of future coronary heart disease events than a baseline CAC score. We determined whether serum gamma-glutamyltransferase (GGT) activity can independently predict the progression of CAC in adults with type 2 diabetes mellitus (T2DM). Patients (n = 326) without symptomatic cardiovascular (CV) disease were evaluated by CAC imaging. The CAC scores were assessed at baseline and after 20 +/- 4 months. Serum GGT activities were significantly higher in progressors compared with nonprogressors (39 +/- 16 vs 27 +/- 11 U/L, P < .001). Multivariable analyses demonstrated that GGT activity retained a strong association with CAC progression after adjustment for CV risk factors. Additionally, there was a graded association between GGT activity quartile and annualized CAC progression. In asymptomatic patients with T2DM, we prospectively found that serum GGT activity may be an independent predictor of CAC progression but not a predictor of CAC incidence.