Elevated serum gamma-glutamyltransferase is associated with an increased risk of oesophageal carcinoma in a cohort of 8,388,256 Korean subjects

PLoS One. 2017 May 5;12(5):e0177053. doi: 10.1371/journal.pone.0177053. eCollection 2017.


Gamma-glutamyltransferase (GGT) is a marker for hepatic injury and alcohol consumption. However, the association of GGT with the risk of oesophageal carcinoma (OC) has not been fully recognized to date. Therefore, this study aimed to determine the association between elevated GGT and OC, by also considering the body mass index (BMI) of the subjects. Clinical data from 8,388,256 Korean individuals, who were aged 40 years and over and who received healthcare check-ups arranged by the national insurance program in 2007 and 2008, were analysed. Newly diagnosed OC was identified using claims data during a median follow-up duration of 8.72 years. During the study period, 6,863 individuals (0.08%) developed OC. We found that there was an increased risk of OC in subjects with serum GGT values >18 IU/L. Furthermore, a BMI <18.5 kg/m2 (underweight) was associated with increased OC risk, while a BMI ≥23.0 kg/m2 was associated with a reduced OC risk. Individuals who were both underweight and in the highest GGT quartile (≥40 IU/L) had a far greater risk of OC compared to other individuals (hazard ratio: 3.65, 95% confidence interval: 3.10-4.30). In conclusion, increased serum GGT was associated with an increased risk of developing OC in the general Korean population, regardless of age, sex, smoker status, or alcohol consumption.

MeSH terms

  • Adult
  • Aged
  • Alcohol Drinking
  • Biomarkers, Tumor / blood*
  • Esophageal Neoplasms / blood
  • Esophageal Neoplasms / enzymology
  • Esophageal Neoplasms / epidemiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Republic of Korea / epidemiology
  • Risk Factors
  • Smoking
  • Thinness
  • gamma-Glutamyltransferase / blood*


  • Biomarkers, Tumor
  • gamma-Glutamyltransferase

Grant support

This work was supported by the Ministry of Science, ICT and Future Planning (http://english.msip.go.kr/english/main/main.do) No. 2011-0030001 to DHL. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.