Prognostic Value of Gamma-Glutamyltransferase in Male Patients With Idiopathic Pulmonary Arterial Hypertension

Background: The elevated gamma-glutamyltransferase (GGT) activity is regarded as an indicator of cardiovascular disease, with males having higher values than females. The greater incidence of idiopathic pulmonary arterial hypertension (IPAH) is observed in women, whereas prognosis is poor in men. Th...

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Main Authors: Gang-Hua Lu, Su-Gang Gong, Chao Li, Qin-Hua Zhao, Rong Jiang, Ci-Jun Luo, Lan Wang, Rui Zhang
Format: Article
Language:English
Published: Frontiers Media S.A. 2020-10-01
Series:Frontiers in Cardiovascular Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fcvm.2020.580908/full
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author Gang-Hua Lu
Su-Gang Gong
Chao Li
Qin-Hua Zhao
Rong Jiang
Ci-Jun Luo
Lan Wang
Lan Wang
Rui Zhang
Rui Zhang
author_facet Gang-Hua Lu
Su-Gang Gong
Chao Li
Qin-Hua Zhao
Rong Jiang
Ci-Jun Luo
Lan Wang
Lan Wang
Rui Zhang
Rui Zhang
author_sort Gang-Hua Lu
collection DOAJ
description Background: The elevated gamma-glutamyltransferase (GGT) activity is regarded as an indicator of cardiovascular disease, with males having higher values than females. The greater incidence of idiopathic pulmonary arterial hypertension (IPAH) is observed in women, whereas prognosis is poor in men. The present study aims to investigate the potential association of GGT on male patients.Methods: Serum GGT levels were measured in 338 consecutive adult IPAH patients, who underwent bone morphogenetic protein receptor type 2 (BMPR2) genetic counseling, and matched with healthy subjects by sex and age. The followed interval was 48 ± 34 months.Results: Increased serum GGT levels were more common in patients with IPAH than controls (p < 0.001). GGT values were significantly higher in male patients than those of females (p < 0.001). Compared with female patients with BMPR2 mutation, GGT level in male patients with BMPR2 mutation was further increased (p = 0.002). Higher GGT levels were associated with worse hemodynamics and Nterminal pro B-type natriuretic peptide in all patients. However, males with a GGT concentration ≥ 53 U/L had a worse survival than those of females. Contrarily, if GGT concentration <53 U/L, there was no survival difference between male and female patients. After adjustment for relevant variables of clinical features and hemodynamics, baseline higher GGT levels remained increased risks of all-cause mortality in males rather than females. During rehospitalization follow-up, male patients still had significantly higher values of GGT than females.Conclusions: Increased GGT levels were correlated with BMPR2 mutation, hemodynamic dysfunction, and poor outcomes in male patients with IPAH. Further studies are needed to explain the origin of abnormal GGT and its potential pathogenesis in men.
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spelling doaj.art-b43c9ecd55d241d1a72a533ec20f7b2c2022-12-21T18:18:43ZengFrontiers Media S.A.Frontiers in Cardiovascular Medicine2297-055X2020-10-01710.3389/fcvm.2020.580908580908Prognostic Value of Gamma-Glutamyltransferase in Male Patients With Idiopathic Pulmonary Arterial HypertensionGang-Hua Lu0Su-Gang Gong1Chao Li2Qin-Hua Zhao3Rong Jiang4Ci-Jun Luo5Lan Wang6Lan Wang7Rui Zhang8Rui Zhang9Tongji University School of Medicine, Shanghai, ChinaDepartment of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, ChinaTongji University School of Medicine, Shanghai, ChinaDepartment of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, ChinaDepartment of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, ChinaTongji University School of Medicine, Shanghai, ChinaDepartment of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, ChinaTongji University School of Medicine, Shanghai, ChinaDepartment of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, ChinaBackground: The elevated gamma-glutamyltransferase (GGT) activity is regarded as an indicator of cardiovascular disease, with males having higher values than females. The greater incidence of idiopathic pulmonary arterial hypertension (IPAH) is observed in women, whereas prognosis is poor in men. The present study aims to investigate the potential association of GGT on male patients.Methods: Serum GGT levels were measured in 338 consecutive adult IPAH patients, who underwent bone morphogenetic protein receptor type 2 (BMPR2) genetic counseling, and matched with healthy subjects by sex and age. The followed interval was 48 ± 34 months.Results: Increased serum GGT levels were more common in patients with IPAH than controls (p < 0.001). GGT values were significantly higher in male patients than those of females (p < 0.001). Compared with female patients with BMPR2 mutation, GGT level in male patients with BMPR2 mutation was further increased (p = 0.002). Higher GGT levels were associated with worse hemodynamics and Nterminal pro B-type natriuretic peptide in all patients. However, males with a GGT concentration ≥ 53 U/L had a worse survival than those of females. Contrarily, if GGT concentration <53 U/L, there was no survival difference between male and female patients. After adjustment for relevant variables of clinical features and hemodynamics, baseline higher GGT levels remained increased risks of all-cause mortality in males rather than females. During rehospitalization follow-up, male patients still had significantly higher values of GGT than females.Conclusions: Increased GGT levels were correlated with BMPR2 mutation, hemodynamic dysfunction, and poor outcomes in male patients with IPAH. Further studies are needed to explain the origin of abnormal GGT and its potential pathogenesis in men.https://www.frontiersin.org/articles/10.3389/fcvm.2020.580908/fullbiomarkersgamma-glutamyltransferasegender differenceidiopathic pulmonary arterial hypertensionprognosis
spellingShingle Gang-Hua Lu
Su-Gang Gong
Chao Li
Qin-Hua Zhao
Rong Jiang
Ci-Jun Luo
Lan Wang
Lan Wang
Rui Zhang
Rui Zhang
Prognostic Value of Gamma-Glutamyltransferase in Male Patients With Idiopathic Pulmonary Arterial Hypertension
Frontiers in Cardiovascular Medicine
biomarkers
gamma-glutamyltransferase
gender difference
idiopathic pulmonary arterial hypertension
prognosis
title Prognostic Value of Gamma-Glutamyltransferase in Male Patients With Idiopathic Pulmonary Arterial Hypertension
title_full Prognostic Value of Gamma-Glutamyltransferase in Male Patients With Idiopathic Pulmonary Arterial Hypertension
title_fullStr Prognostic Value of Gamma-Glutamyltransferase in Male Patients With Idiopathic Pulmonary Arterial Hypertension
title_full_unstemmed Prognostic Value of Gamma-Glutamyltransferase in Male Patients With Idiopathic Pulmonary Arterial Hypertension
title_short Prognostic Value of Gamma-Glutamyltransferase in Male Patients With Idiopathic Pulmonary Arterial Hypertension
title_sort prognostic value of gamma glutamyltransferase in male patients with idiopathic pulmonary arterial hypertension
topic biomarkers
gamma-glutamyltransferase
gender difference
idiopathic pulmonary arterial hypertension
prognosis
url https://www.frontiersin.org/articles/10.3389/fcvm.2020.580908/full
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