Assuntos
Angiopatias Diabéticas/diagnóstico , Idoso , Pressão Sanguínea , Calcinose/diagnóstico por imagem , Cardiomiopatias/diagnóstico por imagem , Artérias Carótidas/diagnóstico por imagem , Análise Custo-Benefício , Diabetes Mellitus Tipo 1/complicações , Angiopatias Diabéticas/economia , Angiopatias Diabéticas/prevenção & controle , Exercício Físico , Humanos , Estilo de Vida , Imageamento por Ressonância Magnética , Guias de Prática Clínica como Assunto , Medição de Risco , Tomografia Computadorizada de Emissão de Fóton Único , Tomografia Computadorizada por Raios X , UltrassonografiaRESUMO
Gamma-glutamyl transferase (GGT) is a second-generation enzymatic liver function test available for several decades, initially used as a sensitive indicator of alcohol ingestion, hepatic inflammation, fatty liver disease, and hepatitis. Longitudinal and cross-sectional investigational studies since 1990 have associated GGT with an increase in all-cause mortality, as well as chronic heart disease events such as congestive heart failure and components of the metabolic syndrome (abnormal body mass index and levels of high-density lipoprotein cholesterol, glucose, triglycerides, and systolic and diastolic blood pressure). In the upper reference range, GGT was found to be an independent biomarker of the metabolic syndrome, with a 20% per GGT quartile trend rise. Additionally, GGT was positively correlated with an 18% per quartile risk of cardiovascular events and a 26% per quartile increased risk of all-cause mortality. Furthermore, it may be considered a biomarker for "oxidative stress" associated with glutathione metabolism and possibly a "proatherogenic" marker because of its indirect relationship in the biochemical steps to low-density lipoprotein cholesterol oxidation. GGT is becoming an important addition to the multimarker approach to cardiovascular risk evaluation. It should be considered a valuable adjunct in stratifying patient risk and in assessing the aggressiveness of appropriate treatment, with hopes of preventing unnecessary cardiac events and deaths in future years.