Association between Gamma-Glutamyl Transferase Levels and Pancreatobiliary Cancer Risk in Patients with Diabetes: Evidence from the National Health Insurance Cooperation Health Checkup 2009 to 2012

Background/Aims: Elevated gamma-glutamyl transferase (GGT) levels indicate hepatic dysfunction and have been linked to an increased risk of pancreatobiliary cancers. However, this association, particularly in individuals with diabetes mellitus (DM), requires elucidation. We aimed to examine the asso...

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Main Authors: Ji Hye Heo, Jun Goo Kang, Kyungdo Han, Kyong Joo Lee
Format: Article
Language:English
Published: Gastroenterology Council for Gut and Liver 2025-03-01
Series:Gut and Liver
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Online Access:http://gutnliver.org/journal/view.html?doi=10.5009/gnl240322
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author Ji Hye Heo
Jun Goo Kang
Kyungdo Han
Kyong Joo Lee
author_facet Ji Hye Heo
Jun Goo Kang
Kyungdo Han
Kyong Joo Lee
author_sort Ji Hye Heo
collection DOAJ
description Background/Aims: Elevated gamma-glutamyl transferase (GGT) levels indicate hepatic dysfunction and have been linked to an increased risk of pancreatobiliary cancers. However, this association, particularly in individuals with diabetes mellitus (DM), requires elucidation. We aimed to examine the association between elevated serum GGT levels and pancreatobiliary cancer risk in patients with diabetes. Methods: Our study included data from the National Health Insurance Service (NHIS) database for 2,459,966 adults aged >20 years diagnosed with DM between 2009 and 2012. We examined the association between serum GGT levels and pancreatobiliary cancer risk, considering DM-related factors. Serum GGT levels were categorized into quartiles, and Cox proportional hazards analysis was performed to evaluate the association between serum GGT levels and pancreatobiliary cancer risk. Results: Over a median follow-up period of 7.2 years, 21,795 patients (0.89%) were newly diagnosed with pancreatobiliary cancer. The adjusted hazard ratio for pancreatobiliary cancer in quartiles 2-4 compared with that in quartile 1 was 1.091, 1.223, and 1.554, respectively, demonstrating a significant upward trend (p<0.001). This association remained consistent across all cancer types and was independent of the DM duration or treatment regimen. Conclusions: Elevated serum GGT levels were independently associated with an increased risk of pancreatobiliary cancer, regardless of the duration of DM or the use of oral hypoglycemic agents and insulin. While these findings suggest the potential utility of serum GGT as a biomarker for identifying individuals at higher risk of pancreatobiliary cancer within the diabetic population, further research is needed to validate its clinical applicability.
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spelling doaj-art-77759bd6c4be439a8e1aab9e0110f65a2025-08-20T02:57:01ZengGastroenterology Council for Gut and LiverGut and Liver1976-22832025-03-0119228629610.5009/gnl240322gnl240322Association between Gamma-Glutamyl Transferase Levels and Pancreatobiliary Cancer Risk in Patients with Diabetes: Evidence from the National Health Insurance Cooperation Health Checkup 2009 to 2012Ji Hye Heo0Jun Goo Kang1Kyungdo Han2Kyong Joo Lee3Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, KoreaDepartment of Internal Medicine, Hallym University College of Medicine, Chuncheon, KoreaDepartment of Statistics and Actuarial Science, Soongsil University, Seoul, KoreaDepartment of Internal Medicine, Hallym University College of Medicine, Chuncheon, KoreaBackground/Aims: Elevated gamma-glutamyl transferase (GGT) levels indicate hepatic dysfunction and have been linked to an increased risk of pancreatobiliary cancers. However, this association, particularly in individuals with diabetes mellitus (DM), requires elucidation. We aimed to examine the association between elevated serum GGT levels and pancreatobiliary cancer risk in patients with diabetes. Methods: Our study included data from the National Health Insurance Service (NHIS) database for 2,459,966 adults aged >20 years diagnosed with DM between 2009 and 2012. We examined the association between serum GGT levels and pancreatobiliary cancer risk, considering DM-related factors. Serum GGT levels were categorized into quartiles, and Cox proportional hazards analysis was performed to evaluate the association between serum GGT levels and pancreatobiliary cancer risk. Results: Over a median follow-up period of 7.2 years, 21,795 patients (0.89%) were newly diagnosed with pancreatobiliary cancer. The adjusted hazard ratio for pancreatobiliary cancer in quartiles 2-4 compared with that in quartile 1 was 1.091, 1.223, and 1.554, respectively, demonstrating a significant upward trend (p<0.001). This association remained consistent across all cancer types and was independent of the DM duration or treatment regimen. Conclusions: Elevated serum GGT levels were independently associated with an increased risk of pancreatobiliary cancer, regardless of the duration of DM or the use of oral hypoglycemic agents and insulin. While these findings suggest the potential utility of serum GGT as a biomarker for identifying individuals at higher risk of pancreatobiliary cancer within the diabetic population, further research is needed to validate its clinical applicability.http://gutnliver.org/journal/view.html?doi=10.5009/gnl240322pancreatobiliary cancergamma-glutamyltransferasediabetes mellitusriskbiomarkers
spellingShingle Ji Hye Heo
Jun Goo Kang
Kyungdo Han
Kyong Joo Lee
Association between Gamma-Glutamyl Transferase Levels and Pancreatobiliary Cancer Risk in Patients with Diabetes: Evidence from the National Health Insurance Cooperation Health Checkup 2009 to 2012
Gut and Liver
pancreatobiliary cancer
gamma-glutamyltransferase
diabetes mellitus
risk
biomarkers
title Association between Gamma-Glutamyl Transferase Levels and Pancreatobiliary Cancer Risk in Patients with Diabetes: Evidence from the National Health Insurance Cooperation Health Checkup 2009 to 2012
title_full Association between Gamma-Glutamyl Transferase Levels and Pancreatobiliary Cancer Risk in Patients with Diabetes: Evidence from the National Health Insurance Cooperation Health Checkup 2009 to 2012
title_fullStr Association between Gamma-Glutamyl Transferase Levels and Pancreatobiliary Cancer Risk in Patients with Diabetes: Evidence from the National Health Insurance Cooperation Health Checkup 2009 to 2012
title_full_unstemmed Association between Gamma-Glutamyl Transferase Levels and Pancreatobiliary Cancer Risk in Patients with Diabetes: Evidence from the National Health Insurance Cooperation Health Checkup 2009 to 2012
title_short Association between Gamma-Glutamyl Transferase Levels and Pancreatobiliary Cancer Risk in Patients with Diabetes: Evidence from the National Health Insurance Cooperation Health Checkup 2009 to 2012
title_sort association between gamma glutamyl transferase levels and pancreatobiliary cancer risk in patients with diabetes evidence from the national health insurance cooperation health checkup 2009 to 2012
topic pancreatobiliary cancer
gamma-glutamyltransferase
diabetes mellitus
risk
biomarkers
url http://gutnliver.org/journal/view.html?doi=10.5009/gnl240322
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