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Serum gamma-glutamyltransferase levels are inversely related to endothelial function in chronic kidney disease

  • Nephrology - Original Paper
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Abstract

Backgrounds

Gamma-glutamyltransferase (GGT) is an enzyme responsible for the extracellular catabolism of the antioxidant glutathione and recently implicated in the pathogenesis of atherosclerosis. Endothelial dysfunction is a prodromal feature of atherogenesis. Since oxidative stress is highly present in uremia and causally linked to endothelial dysfunction, we hypothesized that GGT may be a factor implicated in this process.

Methods

Serum GGT and C-reactive protein (CRP) levels, estimated glomerular filtration rate (eGFR), and 24-h proteinuria were measured in 214 nondiabetic stages 3–5 CKD patients. The endothelium-dependent vasodilatation (FMD) of the brachial artery was assessed by using high-resolution ultrasound. We investigated the relationship between FMD and circulating serum GGT.

Results

Serum GGT levels were negatively associated with FMD (r = −0.41, p < 0.001) and eGFR (r = −0.34, p < 0.001) in univariate analysis. Multivariate regression analysis showed that the association between GGT and FMD persisted after adjustment for age, sex, smoking, renal function (eGFR), inflammation (CRP), proteinuria, and homeostatic model assessment index.

Conclusion

Circulating GGT levels significantly associate with endothelial dysfunction, an important early feature of the atherogenic process. GGT might be an early marker of oxidative or other cellular stress that it is possibly directly related to the pathogenesis of endothelial dysfunction.

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Acknowledgments

We thank the patients and personnel involved in the creation of this patient material. The authors would like to express their sincere appreciation to FAVOR (FMF Arthritis Vasculitis and Orphan Diseases Research/www.favor.org.tr) web registries at Gulhane Military Medical Academy, Institute of Health Sciences for their supports in epidemiological and statistical advisory and invaluable guidance for the preparation of the manuscript. We acknowledge support from the Gülhane School of Medicine in Turkey, the Swedish Research Council, and the Loo and Hans Osterman Foundation.

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Nephrology, Gulhane School of Medicine, Ankara, Turkey

    Mahmut Ilker Yilmaz, Faruk Turgut, Mehmet Kanbay, Hilmi Umut Unal, Mahmut Gok & Erkan Demirkaya

  2. Department of Radiology, Gulhane School of Medicine, Ankara, Turkey

    Mutlu Saglam

  3. Department of Endocrinology, Gulhane School of Medicine, Ankara, Turkey

    Alper Sonmez

  4. Department of Biochemistry, Gulhane School of Medicine, Ankara, Turkey

    Halil Yaman

  5. Department of Internal Medicine, Gulhane School of Medicine, Ankara, Turkey

    Seref Demirbas, Murat Karaman & Seyit Ahmet Ay

  6. Nephrology Clinic, Dialysis and Renal Transplant Center, “C.I. PARHON” University Hospital, “Gr. T. Popa” University of Medicine and Pharmacy, Iasi, Romania

    Adrian Covic

  7. Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital at Huddinge, 141 86, Stockholm, Sweden

    Juan Jesus Carrero

  8. Alparslan Mahallesi, Umit Sokak, No: 25/14, Melikgazi/Kayseri, Turkey

    Mehmet Kanbay

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  1. Mahmut Ilker Yilmaz
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Correspondence to Mehmet Kanbay.

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Yilmaz, M.I., Turgut, F., Kanbay, M. et al. Serum gamma-glutamyltransferase levels are inversely related to endothelial function in chronic kidney disease. Int Urol Nephrol 45, 1071–1078 (2013). https://doi.org/10.1007/s11255-012-0354-2

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