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Opposite Associations of Carbohydrate-Deficient Transferrin and  -Glutamyltransferase With Prevalent Coronary Heart Disease
Pekka Jousilahti, MD, PhD;
Erkki Vartiainen, MD, PhD;
Hannu Alho, MD, PhD;
Kari Poikolainen, MD, PhD;
Pekka Sillanaukee, PhD
Arch Intern Med. 2002;162:817-821.
Background Moderate alcohol consumption may reduce the risk of coronary heart disease
(CHD), but excessive alcohol consumption is probably harmful to the heart.
We analyzed the association of 2 commonly used markers of alcohol consumption—carbohydrate-deficient
transferrin (CDT) and  -glutamyltransferase (GGT)—and self-reported
alcohol consumption with prevalent CHD.
Methods The study included a random sample of 3666 Finnish men aged 25 to 74
years who participated in a risk factor survey in 1997. The cross-sectional
association of CDT, GGT, and self-reported drinking with CHD was analyzed
by means of logistic regression models.
Results The CDT level was inversely and GGT level positively associated with
CHD risk. The odds ratios (adjusted for age, smoking, total and high-density
lipoprotein cholesterol levels, systolic blood pressure, and body mass index)
of CHD among men in the fourth quartiles of CDT and GGT, as compared with
the first quartiles, were 0.69 and 1.76, respectively. In a composite risk
assessment, men with normal CDT levels ( 20 U/L) and elevated GGT levels
(>80 U/L) had nearly 8-fold adjusted risk of CHD as compared with the men
with normal GGT levels and elevated CDT levels. Self-reported alcohol consumption
had an inverse association with CHD risk, which disappeared after adjustment
for the other risk factors.
Conclusions Levels of CDT and GGT may be indicators of factors behind the curvilinear
association between alcohol consumption and CHD risk. The CDT level seems
to be related to beneficial biological changes and GGT level with the changes
that are detrimental to the cardiovascular system. The inverse association
of CDT level with CHD risk will be examined further in a forthcoming prospective
study.
From the Department of Public Health (Dr Jousilahti) and Research Unit
of Substance Abuse Medicine (Dr Alho), University of Helsinki, Helsinki; Department
of Epidemiology and Health Promotion (Drs Jousilahti and Vartiainen) and Department
of Mental Health and Alcohol Research (Dr Alho), National Public Health Institute,
Helsinki; Finnish Foundation for Alcohol Studies, Helsinki (Dr Poikolainen);
Oy Finnish Immunotechnology Ltd, Tampere (Dr Sillanaukee); and Department
of Medical Biochemistry and Research Unit, Tampere University and University
Hospital, Tampere (Dr Sillanaukee), Finland.
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