Serum γ-glutamyl transferase as a novel risk indicator for lung cancer: insights from four million Koreans

Abstract Background γ-glutamyl transferase (GGT) is associated with carcinogenesis, cancer progression, and metastasis. We investigated associations between serum GGT levels and lung cancer in the Korean general population. Methods Individuals participating in the national health examination in 2012...

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Main Authors: Chiwook Chung, Kyu Na Lee, Dong Wook Shin, Sei Won Lee, Kyungdo Han
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Respiratory Research
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Online Access:https://doi.org/10.1186/s12931-025-03317-3
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author Chiwook Chung
Kyu Na Lee
Dong Wook Shin
Sei Won Lee
Kyungdo Han
author_facet Chiwook Chung
Kyu Na Lee
Dong Wook Shin
Sei Won Lee
Kyungdo Han
author_sort Chiwook Chung
collection DOAJ
description Abstract Background γ-glutamyl transferase (GGT) is associated with carcinogenesis, cancer progression, and metastasis. We investigated associations between serum GGT levels and lung cancer in the Korean general population. Methods Individuals participating in the national health examination in 2012 were screened in the Korean National Health Information Database. Overall, 2,414,755 males and 2,032,241 females aged ≥ 20 years were followed up until December 2022. Of these individuals, 25,728 males and 11,706 females were diagnosed with lung cancer based on health-insurance claims. Serum GGT levels were categorized into quartiles Q1 (low)–Q4 (high) or deciles D1 (low)–D10 (high). Multivariate Cox proportional hazard models were used to estimate the adjusted hazard ratio (aHR) of risk factors for lung cancer. Results In quartile categories, the highest quartile of serum GGT levels (Q4, males: ≥54 IU/L; females: ≥24 IU/L) had the highest incidence (males: 1.24/1,000 person-years; females: 0.79/1,000 person-years) and risk (males: aHR 1.37, 95% confidence interval [CI] 1.32–1.42; females: aHR 1.13, 95% CI 1.06–1.19) of lung cancer. In the decile categories, the incidence and risk of lung cancer increased with increasing serum GGT levels, resulting in the highest risk of lung cancer in the D10 category (males: ≥93 IU/L, aHR 1.57, 95% CI 1.48–1.67; females: ≥37 IU/L, aHR 1.20, 95% CI 1.10–1.31). Stratified analyses identified age (middle-aged/older adults), smoking status (never/former smokers), or alcohol consumption (non/mild alcohol drinkers [< 10 g/day]) to be prominently associated with higher lung cancer risks. Conclusions Increased serum levels of GGT correlated with higher risk of lung cancer, even after adjusting for smoking status, alcohol consumption, and chronic liver disease. These effects were more prominent in never/former smokers and in non/mild alcohol drinkers. Clinical trial number not applicable.
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spelling doaj-art-2ef1ebf147cf459684c2e2d5458443482025-08-20T03:05:56ZengBMCRespiratory Research1465-993X2025-07-0126111210.1186/s12931-025-03317-3Serum γ-glutamyl transferase as a novel risk indicator for lung cancer: insights from four million KoreansChiwook Chung0Kyu Na Lee1Dong Wook Shin2Sei Won Lee3Kyungdo Han4Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of MedicineDepartment of Statistics and Actuarial Science, Soongsil UniversityDepartment of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of MedicineDepartment of Statistics and Actuarial Science, Soongsil UniversityAbstract Background γ-glutamyl transferase (GGT) is associated with carcinogenesis, cancer progression, and metastasis. We investigated associations between serum GGT levels and lung cancer in the Korean general population. Methods Individuals participating in the national health examination in 2012 were screened in the Korean National Health Information Database. Overall, 2,414,755 males and 2,032,241 females aged ≥ 20 years were followed up until December 2022. Of these individuals, 25,728 males and 11,706 females were diagnosed with lung cancer based on health-insurance claims. Serum GGT levels were categorized into quartiles Q1 (low)–Q4 (high) or deciles D1 (low)–D10 (high). Multivariate Cox proportional hazard models were used to estimate the adjusted hazard ratio (aHR) of risk factors for lung cancer. Results In quartile categories, the highest quartile of serum GGT levels (Q4, males: ≥54 IU/L; females: ≥24 IU/L) had the highest incidence (males: 1.24/1,000 person-years; females: 0.79/1,000 person-years) and risk (males: aHR 1.37, 95% confidence interval [CI] 1.32–1.42; females: aHR 1.13, 95% CI 1.06–1.19) of lung cancer. In the decile categories, the incidence and risk of lung cancer increased with increasing serum GGT levels, resulting in the highest risk of lung cancer in the D10 category (males: ≥93 IU/L, aHR 1.57, 95% CI 1.48–1.67; females: ≥37 IU/L, aHR 1.20, 95% CI 1.10–1.31). Stratified analyses identified age (middle-aged/older adults), smoking status (never/former smokers), or alcohol consumption (non/mild alcohol drinkers [< 10 g/day]) to be prominently associated with higher lung cancer risks. Conclusions Increased serum levels of GGT correlated with higher risk of lung cancer, even after adjusting for smoking status, alcohol consumption, and chronic liver disease. These effects were more prominent in never/former smokers and in non/mild alcohol drinkers. Clinical trial number not applicable.https://doi.org/10.1186/s12931-025-03317-3GGTLung cancerSmokingAlcohol consumption
spellingShingle Chiwook Chung
Kyu Na Lee
Dong Wook Shin
Sei Won Lee
Kyungdo Han
Serum γ-glutamyl transferase as a novel risk indicator for lung cancer: insights from four million Koreans
Respiratory Research
GGT
Lung cancer
Smoking
Alcohol consumption
title Serum γ-glutamyl transferase as a novel risk indicator for lung cancer: insights from four million Koreans
title_full Serum γ-glutamyl transferase as a novel risk indicator for lung cancer: insights from four million Koreans
title_fullStr Serum γ-glutamyl transferase as a novel risk indicator for lung cancer: insights from four million Koreans
title_full_unstemmed Serum γ-glutamyl transferase as a novel risk indicator for lung cancer: insights from four million Koreans
title_short Serum γ-glutamyl transferase as a novel risk indicator for lung cancer: insights from four million Koreans
title_sort serum γ glutamyl transferase as a novel risk indicator for lung cancer insights from four million koreans
topic GGT
Lung cancer
Smoking
Alcohol consumption
url https://doi.org/10.1186/s12931-025-03317-3
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