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Original Article
The Association Between Serum GGT Level and Bone Mineral Density in Postmenopausal Women
Heung Yeol Kim1, Eun Hee Kong2
Kosin Medical Journal 2013;28(1):35-41.
DOI: https://doi.org/10.7180/kmj.2013.28.1.35
Published online: January 19, 2013

1Department of Obstetrics and Gynecology, College of Medicine, Kosin University, Busan, Korea

2Department of Family Medicine, College of Medicine, Kosin University, Busan, Korea

Corresponding author: Eun Hee Kong, Department of Family Medicine, Kosin University College of Medicine, #34, Amnam-dong, Seo-gu, Busan, 602-702, Korea TEL: 051-990-6365 FAX: 051-990-3045 E-mail: eh-kong@kosin.ac.kr
• Received: October 19, 2012   • Accepted: January 2, 2013

Copyright © 2013 Kosin University School of Medicine Proceedings

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Objectives
    The aim of this study was to identify the relationship between serum gamma-glutamyltransferase (GGT) and bone mineral density (BMD) in postmenopausal women.
  • Methods
    We evaluated 200 postmenopausal women who were visiting a health promotion center at a university hospital from January 2009 to December 2011. Their current medical diseases and medication history were collected through medical records. Basic physical examinations and laboratory tests were performed on all subjects.
  • Results
    The levels of serum GGT within their normal range were positively correlated with waist circumference (P = 0.01), triglycerides (P <0.001), alkaline phosphatase (P = 0.009), and uric acid (P = 0.01). The serum GGT within their normal range were negatively associated with the femur neck BMD (P = 0.002). In adjusted analysis including age and body mass index, the BMD of the femur neck was more strongly associated with a high-normal serum GGT level among the postmenopausal women as compared with those with a low-normal serum GGT level (P = 0.02).
  • Conclusions
    Serum GGT within its normal range is negatively correlated with the BMD in the femur neck among postmenopausal women. It can be useful for selecting a group that is at high risk for the bone fracture regardless of the underlying mechanism.
Table 1.
General characteristics. (N=200)
Characteristics Mean ± SD
Age, y 57.71 ± 6.29
Weight, kg 59.14 ± 8.12
Height, cm 156.38 ± 5.28
BMI, kg/m2 24.19 ± 3.23
WC, cm 80.22 ± 8.23
SBP, mmHg DBP, mmHg 125.99 ± 16.35 76.70 ± 10.00
Glucose, mg/dL 94.09 ± 21.16
T-C, mg/dL HDL-C, mg/dL 206.00 ± 36.71 53.09 ± 12.56
LDL-C, mg/dL 135.82 ± 17.34
TG, mg/dL 119.91 ± 60.19
ALP, mg/dL 66.81 ± 19.83
GGT, mg/dL 18.71 ± 9.53
Uric acid, mg/dL 4.48 ± 0.91
Calcium, mg/dL 9.35 ± 0.38
Phosphate, mg/dL 3.74 ± 0.56
Hs-CRP, mg/dL 0.17 ± 0.52
F-BMD, T-score (SD) -1.53 ± 1.47
L-BMD, T-score (SD) -1.97 ± 1.07

cholesterol, HDL-C: high density lipoprotein cholesterol, LDL-C: low density lipoprotein cholesterol TG: triglyceride, ALP: alkaline phosphatase, GGT: gamma-glutamyl transferase, Hs-CRP: high sensitivity C-reactive protein, F-BMD: bone mineral density of Femur neck, L-BMD: bone mineral density of Lumbar spine (L1~L4).

Table 2.
Association with biochemical markers by the quartile of normal serum GGT levels.
Quartile of normal serum GGT levels (mg/dL) P-value
Q1 (4~12) (N = 50) Q2 (13~15) (N = 50) Q3 (16~23) (N = 50) Q4 (24~50) (N = 50)
Age, y 57.02 ± 6.24 56.55 ± 5.52 58.75 ± 6.49 58.50 ± 6.71 0.17
Weight, kg 57.76 ± 7.40 58.13 ± 7.81 59.75 ± 7.86 60.86 ± 9.12 0.15
Height, cm 156.72 ± 5.45 156.54 ± 5.52 156.16 ± 4.70 156.13 ± 5.55 0.91
BMI, kg/m2 23.50 ± 2.66 23.76 ± 3.40 24.52 ± 3.14 24.97 ± 3.52 0.06
WC, cm 78.55 ± 7.24 78.27 ± 8.20 81.54 ± 7.68 82.46 ± 9.06 0.01
SBP, mmHg 123.29 ± 15.69 125.65 ± 12.96 124.59 ± 17.27 130.38 ± 18.44 0.11
DBP, mmHg 74.93 ± 10.97 76.85 ± 8.75 76.48 ± 9.51 78.52 ± 10.56 0.30
Glucose, mg/dL 91.45 ± 23.28 93.31 ± 16.72 92.61 ± 13.72 98.91 ± 27.77 0.25
T-C, mg/dL 197.47 ± 37.33 205.87 ± 37.61 209.20 ± 36.21 211.31 ± 35.13 0.20
HDL-C, mg/dL 52.20 ± 11.42 55.60 ± 15.58 52.88 ± 11.39 51.73 ± 11.35 0.37
LDL-C, mg/dL 131.48 ± 11.42 132.45 ± 15.58 134.23 ± 11.39 135.71 ± 11.35 0.35
TG, mg/dL 107.75 ± 45.65 107.78 ± 47.28 113.91 ± 42.96 149.77 ± 85.04 < 0.001
ALP, mg/dL 61.58 ± 15.00 63.36 ± 18.77 69.41 ± 22.77 72.73 ± 20.31 0.009
Uric acid, mg/dL 4.23 ± 0.81 4.34 ± 0.85 4.62 ± 0.78 4.73 ± 1.09 0.01
Calcium, mg/dL 9.31 ± 0.36 9.34 ± 0.36 9.36 ± 0.40 9.38 ± 0.41 0.79
Phosphate, mg/dL 3.67 ± 0.42 3.71 ± 0.45 3.75 ± 0.53 3.78 ± 0.43 0.47
Hs-CRP, mg/dL 0.15 ± 0.19 0.12 ± 0.13 0.25 ± 0.95 0.18 ± 0.36 0.59
F-BMD, T-score (SD) -1.16 ± 1.60 -1.24 ± 1.41 -1.35 ± 1.56 -1.64 ± 1.29 0.002
L-BMD, T-score (SD) -1.71 ± 1.13 -1.62 ± 1.05 -2.45 ± 1.07 -2.13 ± 1.03 0.33

Data shown are mean ± SD Note: P-value by one way ANOVA analysis

Table 3.
Association with biochemical markers by the BMD T-scores of femur neck
Bone mineral density of femur neck
P-value
T-score ≥ -1.0 -2.5 < T-score < -1.0 T-score ≤ -2.5
(N = 103) (N = 66) (N = 31)
Age, y 54.49 ± 4.46 57.09 ± 5.13 61.55 ± 6.90 < 0.001
Weight, kg 60.29 ± 8.63 60.559 ± 7.55 56.57 ± 7.62 0.003
Height, cm 157.28 ± 5.19 156.72 ± 5.12 155.16 ± 5.38 0.04
BMI, kg/m2 24.39 ± 3.47 24.68 ± 3.12 23.50 ± 3.01 0.06
WC, cm 79.54 ± 9.18 80.39 ± 7.03 80.72 ± 8.40 0.66
SBP, mmHg 124.62 ± 17.07 124.28 ± 13.26 129.07 ± 18.09 0.13
DBP, mmHg 76.24 ± 11.00 75.72 ± 9.348 78.15 ± 9.538 0.29
Glucose, mg/dL 93.38 ± 23.46 92.46 ± 12.59 96.42 ± 25.26 0.49
T-C, mg/dL 209.41 ± 35.33 203.10 ± 35.57 205.49 ± 39.31 0.57
HDL-C, mg/dL 53.96 ± 11.73 52.01 ± 13.98 53.31 ± 11.94 0.63
LDL-C, mg/dL 129.48 ± 10.42 134.51 ± 15.38 130.23 ± 12.79 0.53
TG, mg/dL 120.30 ± 47.96 115.89 ± 57.50 123.54 ± 73.02 0.74
ALP, mg/dL 62.80 ± 18.35 67.20 ± 17.21 70.43 ± 22.97 0.06
GGT, mg/dL 14.26 ± 10.40 19.31 ± 10.39 25.57 ± 7.54 < 0.001
Uric acid, mg/dL 4.38 ± 0.83 4.52 ± 0.80 4.55 ± 1.07 0.50
Calcium, mg/dL 9.32 ± 0.34 9.38 ± 0.40 9.35 ± 0.41 0.59
Phosphate, mg/dL 3.71 ± 0.42 3.74 ± 0.45 3.77 ± 0.53 0.45
Hs-CRP, mg/dL 0.22 ± 0.83 0.13 ± 0.16 0.16 ± 0.31 0.62

Data shown are mean ± SD

Note: P-value by one way ANOVA analysis

Table 4.
Multiple linear regression analysis for associated biochemical markers of BMD T-score of femur neck
Variables B Standard error Beta P-value
WC, cm -0.019 0.01 -0.146 0.16
SBP, mmHg 0.004 0.008 0.062 0.58
DBP, mmHg -0.003 0.01 -0.024 0.82
Glucose, mg/dL 0.002 0.003 0.031 0.62
T-C, mg/dL 0.001 0.002 0.048 0.46
HDL-C, mg/dL -0.002 0.006 -0.027 0.70
LDL-C, mg/dL -0.023 0.006 -0.037 0.65
TG, mg/dL -0.002 0.001 -0.125 0.08
ALP, mg/dL -0.004 0.003 -0.076 0.22
GGT, mg/dL 0.115 0.007 0.324 0.02
Uric acid, mg/dL -0.019 0.07 -0.016 0.81
Calcium, mg/dL -0.208 0.17 -0.075 0.23
Phosphate, mg/dL -0.117 0.15 -0.076 0.41
Hs-CRP, mg/dL 0.003 0.12 0.001 0.98
(constant) 0.893 2.73 0.74

Note: P-value from multiple linear regression analysis. Adjusted by age and BMI.

Table 5.
Multiple linear regression analysis for associated biochemical markers of BMD T-score of lumbar spine (L1~L4)
Variables B Standard error Beta P-value
WC, cm -0.005 0.01 -0.028 0.79
SBP, mmHg 0.002 0.01 0.024 0.83
DBP, mmHg -0.002 0.01 -0.010 0.92
Glucose, mg/dL 0.007 0.005 0.099 0.12
T-C, mg/dL 0.002 0.003 0.059 0.37
HDL-C, mg/dL 0.006 0.009 0.053 0.70
LDL-C, mg/dL 0.016 0.009 0.043 0.62
TG, mg/dL -0.001 0.002 -0.048 0.51
ALP, mg/dL -0.010 0.005 -0.136 0.03
GGT, mg/dL 0.008 0.01 0.052 0.41
Uric acid, mg/dL 0.044 0.11 0.027 0.69
Calcium, mg/dL 0.009 0.24 0.002 0.97
Phosphate, mg/dL 0.006 0.32 0.003 0.65
Hs-CRP, mg/dL -0.062 0.16 -0.022 0.71
(constant) -3.203 3.82 0.40

Note: P-value from multiple linear regression analysis. Adjusted by age and BMI

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