J Clin Neurol.  2020 Jan;16(1):60-65. 10.3988/jcn.2020.16.1.60.

Effects of Gamma-Glutamyl Transferase on Stroke Occurrence Mediated by Atrial Fibrillation

• Yang W
• Kang DW
• Lee SH

• KMID: 2467785
• DOI: http://doi.org/10.3988/jcn.2020.16.1.60

Abstract

BACKGROUND AND PURPOSE
Gamma-glutamyl transferase (GGT) is reported to be associated with stroke independently of the conventional risk factors. However, the underlying mechanism remains to be identified. This study focused on atrial fibrillation (AF), which also reportedly has a close association with GGT.
METHODS
Acute ischemic stroke patients who were admitted to the Seoul National University Hospital within 7 days of stroke onset were analyzed. Multinomial logistic regression was performed to assess the relationship between GGT and cardioembolic stroke. Mediation analysis based on binary logistic regression was used to determine whether AF mediates the relationship between GGT and cardioembolic stroke.
RESULTS
AF was found in 132 (15.0%) of 880 eligible patients with acute ischemic stroke, and 270 (30.7%) patients were categorized as cardioembolic stroke. High GGT levels in acute ischemic stroke patients was associated with cardioembolic stroke [odds ratio (OR)=3.42, 95% CI=1.59-7.37], but not with large-artery atherosclerosis stroke (OR=1.10, 95% CI=0.54-2.23). Approximately half (53.9%) of the total effect of GGT levels on cardioembolic stroke was mediated by AF.
CONCLUSIONS
The GGT level was significantly associated with cardioembolic stroke via AF. The results obtained in the present study may explain why GGT is associated with stroke.

Keyword

stroke; gamma-glutamyl transferase; biomarkers; atrial fibrillation; cardioembolic stroke

MeSH Terms

Atherosclerosis
Atrial Fibrillation*
Biomarkers
Humans
Logistic Models
Negotiating
Risk Factors
Seoul
Stroke*
Transferases*
Biomarkers
Transferases

Figure

• 

  Fig. 1 Mediating role of AF on the effect of GGT on cardioembolic stroke. The effect of GGT on cardioembolic stroke was partially mediated by AF. Path values are standardized regression coefficients. *p<0.05. AF: atrial fibrillation, GGT: gamma-glutamyl transferase.

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