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. 2002 Feb;56(Suppl 1):i25–i29. doi: 10.1136/jech.56.suppl_1.i25

γ-Glutamyltransferase and risk of stroke: the EUROSTROKE project

M Bots, J Salonen, P Elwood, Y Nikitin, d Freire, D Inzitari, J Sivenius, A Trichopoulou, J Tuomilehto, P Koudstaal, D Grobbee
PMCID: PMC1765511  PMID: 11815641

Abstract

Background: Alcohol consumption has been implicated in the aetiology of stroke. As data on alcohol consumption obtained by questionnaire are susceptible to missclassification, this study evaluated the assocation between γ-glutamyltransferase (γ-GT), as a marker for alcohol consumption, and fatal, non-fatal, haemorrhagic and ischaemic stroke in three European cohort studies, participating in EUROSTROKE.

Methods: EUROSTROKE is a collaborative project among ongoing European cohort studies on incidence and risk factors of stroke. EUROSTROKE is designed as a nested case-control study. For each stroke case, two controls were sampled. Strokes were classified according to MONICA criteria or reviewed by a panel of four neurologists. At present, data on stroke and γ-GT were available from cohorts in Cardiff (57 cases), Kuopio (66 cases), and Rotterdam (108 cases).

Results: An increase in γ-GT of one standard deviation (28.7 IU/ml) was associated with an age and sex adjusted 26% (95% CI 5 to 53) increase in risk of stroke. Adjustment for confounding variables such as drug use, history of myocardial infarction, total cholesterol, and diabetes mellitus did not materially attenuate the association. The risk of haemorrhagic stroke increased linearly with increase in γ-GT. The association for cerebral infarction was not graded: the risk increased beyond the first quartile, and remained increased. The association of γ-GT with stroke was significantly stronger among subjects without diabetes mellitus compared with subjects with diabetes mellitus (no association observed).

Conclusion: This EUROSTROKE analysis showed that an increased γ-GT, as a marker of alcohol consumption, is associated with increased risk of stroke, in particular haemorrhagic stroke.

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Selected References

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  1. Bamford J., Sandercock P., Dennis M., Burn J., Warlow C. Classification and natural history of clinically identifiable subtypes of cerebral infarction. Lancet. 1991 Jun 22;337(8756):1521–1526. doi: 10.1016/0140-6736(91)93206-o. [DOI] [PubMed] [Google Scholar]
  2. Bots M. L., Hoes A. W., Koudstaal P. J., Hofman A., Grobbee D. E. Common carotid intima-media thickness and risk of stroke and myocardial infarction: the Rotterdam Study. Circulation. 1997 Sep 2;96(5):1432–1437. doi: 10.1161/01.cir.96.5.1432. [DOI] [PubMed] [Google Scholar]
  3. Camargo C. A., Jr Moderate alcohol consumption and stroke. The epidemiologic evidence. Stroke. 1989 Dec;20(12):1611–1626. doi: 10.1161/01.str.20.12.1611. [DOI] [PubMed] [Google Scholar]
  4. Grobbee D. E., Koudstaal P. J., Bots M. L., Amaducci L. A., Elwood P. C., Ferro J., Freire de Concalves A., Krüger O., Inzitari D., Nikitin Y. Incidence and risk factors of ischaemic and haemorrhagic stroke in Europe. EUROSTROKE: A collaborative study among research centres in Europe: rationale and design. Neuroepidemiology. 1996;15(6):291–300. doi: 10.1159/000109919. [DOI] [PubMed] [Google Scholar]
  5. Hansagi H., Romelsjö A., Gerhardsson de Verdier M., Andréasson S., Leifman A. Alcohol consumption and stroke mortality. 20-year follow-up of 15,077 men and women. Stroke. 1995 Oct;26(10):1768–1773. doi: 10.1161/01.str.26.10.1768. [DOI] [PubMed] [Google Scholar]
  6. Hoeksema H. L., de Bock G. H. The value of laboratory tests for the screening and recognition of alcohol abuse in primary care patients. J Fam Pract. 1993 Sep;37(3):268–276. [PubMed] [Google Scholar]
  7. Hofman A., Grobbee D. E., de Jong P. T., van den Ouweland F. A. Determinants of disease and disability in the elderly: the Rotterdam Elderly Study. Eur J Epidemiol. 1991 Jul;7(4):403–422. doi: 10.1007/BF00145007. [DOI] [PubMed] [Google Scholar]
  8. Jamrozik K., Broadhurst R. J., Anderson C. S., Stewart-Wynne E. G. The role of lifestyle factors in the etiology of stroke. A population-based case-control study in Perth, Western Australia. Stroke. 1994 Jan;25(1):51–59. doi: 10.1161/01.str.25.1.51. [DOI] [PubMed] [Google Scholar]
  9. Nilssen O., Førde O. H., Brenn T. The Tromsø Study. Distribution and population determinants of gamma-glutamyltransferase. Am J Epidemiol. 1990 Aug;132(2):318–326. doi: 10.1093/oxfordjournals.aje.a115661. [DOI] [PubMed] [Google Scholar]
  10. Palmer A. J., Fletcher A. E., Bulpitt C. J., Beevers D. G., Coles E. C., Ledingham J. G., Petrie J. C., Webster J., Dollery C. T. Alcohol intake and cardiovascular mortality in hypertensive patients: report from the Department of Health Hypertension Care Computing Project. J Hypertens. 1995 Sep;13(9):957–964. doi: 10.1097/00004872-199509000-00004. [DOI] [PubMed] [Google Scholar]
  11. Peck K., Shinton R., Beevers G. Is serum gamma-glutamyl transferase a good marker of alcohol intake in stroke patients? Postgrad Med J. 1990 Sep;66(779):710–713. doi: 10.1136/pgmj.66.779.710. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Rimm E. B., Klatsky A., Grobbee D., Stampfer M. J. Review of moderate alcohol consumption and reduced risk of coronary heart disease: is the effect due to beer, wine, or spirits. BMJ. 1996 Mar 23;312(7033):731–736. doi: 10.1136/bmj.312.7033.731. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Salonen J. T., Salonen R., Seppänen K., Rauramaa R., Tuomilehto J. HDL, HDL2, and HDL3 subfractions, and the risk of acute myocardial infarction. A prospective population study in eastern Finnish men. Circulation. 1991 Jul;84(1):129–139. doi: 10.1161/01.cir.84.1.129. [DOI] [PubMed] [Google Scholar]
  14. Thrift A. G., Donnan G. A., McNeil J. J. Epidemiology of intracerebral hemorrhage. Epidemiol Rev. 1995;17(2):361–381. doi: 10.1093/oxfordjournals.epirev.a036199. [DOI] [PubMed] [Google Scholar]
  15. Tuomilehto J., Sarti C., Narva E. V., Salmi K., Sivenius J., Kaarsalo E., Salomaa V., Torppa J. The FINMONICA Stroke Register. Community-based stroke registration and analysis of stroke incidence in Finland, 1983-1985. Am J Epidemiol. 1992 Jun 1;135(11):1259–1270. doi: 10.1093/oxfordjournals.aje.a116232. [DOI] [PubMed] [Google Scholar]
  16. Willems J. L., Abreu-Lima C., Arnaud P., van Bemmel J. H., Brohet C., Degani R., Denis B., Gehring J., Graham I., van Herpen G. The diagnostic performance of computer programs for the interpretation of electrocardiograms. N Engl J Med. 1991 Dec 19;325(25):1767–1773. doi: 10.1056/NEJM199112193252503. [DOI] [PubMed] [Google Scholar]
  17. van Bemmel J. H., Kors J. A., van Herpen G. Methodology of the modular ECG analysis system MEANS. Methods Inf Med. 1990 Sep;29(4):346–353. [PubMed] [Google Scholar]

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