A Nonlinear Association Between Gamma-Glutamyltransferase to High-Density Lipoprotein Cholesterol Ratio and Arterial Stiffness in Japanese Population: A Secondary Analysis Based on a Cross-Sectional Study

Background: Evidences suggested that gamma-glutamyltransferase (GGT) to high-density lipoprotein cholesterol (HDL-C) ratio (GTHR) was a reliable surrogate indicator for fatty liver disease, diabetes, metabolic syndrome. However, the relationship between GTHR and the presence of arterial stiffness remains unclear in healthy population. In the present study, we aimed to explore the association between GTHR and arterial stiffness (AS) in a health check-up population from Japan. Methods: This study is a secondary analysis from a health check-up program carried out at Murakami Memorial Hospital, Gifu, Japan between March 2004 and December 2012. A total of 912 individuals were included in this study. Patients were divided into three groups according to the tertiles of LogGTHR. The univariate linear regression model and the multivariate models were performed to explore the association between between LogGTHR and baPWV. Smoothed curve fit analysis was used to explore the linear or the nonlinear relationship between LogGTHR and baPWV. The modification and interaction of subgroup were inspected by the likelihood ration test. Results: After adjusting for confounders, there is a nonlinear relationship between LogGTHR and baPWV (β=30.08, 95%CI: −33.12 to 93.29, P =0.351). The inflection point was 1.43. When K<1.43 (80.37% of the participants), the relationship was positively correlated (β=165.15, 95%CI: 62.72 to 267.58, P =0.0016), while when ≥1.43, there was a negative association between LogGTHR and baPWV (β= −106.23, 95%CI: –209.25 to −3.21, P =0.0436). Subgroup analysis suggested that LogGTHR was not associated with baPWV in any of these subgroups. Conclusion: In this cross-sectional study, there was a nonlinear positive association between LogGTHR and AS. LogGTHR was positively related with baPWV when less than 1.43, while this association was negative when LogGTHR was >1.43.