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The association between AF and \u03b3-Glutamyltransferase (GGT) was not fully established. This study demonstrated the independent association of cumulative GGT score and AF incidence with the dose-response relationship. Using the Korean National Health Insurance Corporation database, adult subjects who had 4 consecutive annual health examinations from 2009 to 2012 were enrolled. A cumulative GGT score was calculated as the cumulative number of the highest GGT quartile amongst four examinations (0\u20134 times). A multivariable Cox proportional hazards regression analysis was performed. Among a total of 3,500,847 people included, AF was developed in 27,752 people (0.793%) during a median of 8.0 years of follow up. The incidence rate of AF and adjusted hazard ratio were increased by a stepwise manner in the higher quartile group and cumulative GGT score group. In subgroup analysis, this trend was more prominent in the elderly, people without hypertension, non-obese people, and people without any four comorbidities (diabetes mellitus, hypertension, dyslipidemia, and obesity). Our results suggest multiple accumulation of elevated GGT levels in health examination might be a useful marker for risk stratification of AF development, especially in the elderly and healthy population.<\/jats:p>","DOI":"10.1038\/s41598-023-40689-2","type":"journal-article","created":{"date-parts":[[2023,8,23]],"date-time":"2023-08-23T10:02:13Z","timestamp":1692784933000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Association between the accumulation of elevated serum \u03b3-glutamyltransferase level and risk of atrial fibrillation: a nationwide cohort study"],"prefix":"10.1038","volume":"13","author":[{"given":"Won Kyeong","family":"Jeon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"So-Ryoung","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung-Do","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eue-Keun","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seil","family":"Oh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Y. 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EKC: Research grants or speaking fees from Abbott, Bayer, BMS\/Pfizer, Biosense Webster, Chong Kun Dang, Daewoong Pharmaceutical Co., Daiichi-Sankyo, DeepQure, Dreamtech Co., Ltd., Jeil Pharmaceutical Co. Ltd, Medtronic, Samjinpharm, Seers Technology, and Skylabs. GYHL: Consultant and speaker for BMS\/Pfizer, Boehringer Ingelheim and Daiichi-Sankyo. No fees are received personally.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"13771"}}