{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T05:41:40Z","timestamp":1780983700386,"version":"3.54.1"},"reference-count":49,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2020,12,2]],"date-time":"2020-12-02T00:00:00Z","timestamp":1606867200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007771","name":"\u015al\u0105ski Uniwersytet Medyczny","doi-asserted-by":"publisher","award":["KNW-1-079\/K\/9\/Z"],"award-info":[{"award-number":["KNW-1-079\/K\/9\/Z"]}],"id":[{"id":"10.13039\/100007771","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: No previous study has investigated the association between gamma glutamyltransferase (GGT) and vitamin D in patients with stable coronary artery disease (CAD). We investigated the cross-sectional associations between vitamin D status as assessed by serum 25(OH)D and GGT. Methods: 169 patients were enrolled. Study population was divided into three groups: 1: 25(OH)D &lt; 10 ng\/mL (n = 59); 2: 25(OH)D 10\u201320 ng\/mL (n = 82), and 3: 25(OH)D &gt; 20 ng\/mL (n = 28). Based on a cut-off GGT value identified in ROC analysis, we also divided the study population to compare the following groups: GGT \u226419 (n = 66) and GGT &gt;19 (n = 103). Results: GGT activity was the highest in vitamin D severely deficient patients and the lowest in vitamin D insufficient patients. GGT was inversely correlated with 25(OH)D concentrations (R = \u22120.23; p = 0.002). The receiver operating characteristics curve identified the discrimination threshold of GGT of &gt;19 U\/L in predicting vitamin D deficiency. Higher leukocyte and neutrophil counts and lower 25(OH)D concentration were found in patients with GGT &gt; 19 U\/L. Conclusions: We identified an interaction between declining 25(OH)D levels and rising GGT levels with increasing age, which resulted in an unfavorable 25(OH)D-to-GGT ratio in stable CAD patients. These results suggest that these changes might further contribute to a high cardiovascular risk in the elderly.<\/jats:p>","DOI":"10.3390\/ijerph17238980","type":"journal-article","created":{"date-parts":[[2020,12,2]],"date-time":"2020-12-02T20:25:49Z","timestamp":1606940749000},"page":"8980","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Serum Gamma Glutamyltransferase Is Associated with 25-Hydroxyvitamin D Status in Elderly Patients with Stable Coronary Artery Disease"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1867-1326","authenticated-orcid":false,"given":"Aleksander","family":"Danikiewicz","sequence":"first","affiliation":[{"name":"Department of Nutrition Related Prevention, Faculty of Health Sciences in Bytom, Medical University of Silesia, 41-900 Bytom, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3880-5325","authenticated-orcid":false,"given":"Bartosz","family":"Hudzik","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Disease Prevention, Faculty of Health Sciences in Bytom, Medical University of Silesia, 41-900 Bytom, Poland"},{"name":"Third Department of Cardiology, Silesian Center for Heart Disease, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-800 Zabrze, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justyna","family":"Nowak","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Disease Prevention, Faculty of Health Sciences in Bytom, Medical University of Silesia, 41-900 Bytom, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6156-6364","authenticated-orcid":false,"given":"Joanna","family":"Kowalska","sequence":"additional","affiliation":[{"name":"Department of Nutrition Related Prevention, Faculty of Health Sciences in Bytom, Medical University of Silesia, 41-900 Bytom, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iwona","family":"Ziele\u0144-Zynek","sequence":"additional","affiliation":[{"name":"Department of Nutrition Related Prevention, Faculty of Health Sciences in Bytom, Medical University of Silesia, 41-900 Bytom, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janusz","family":"Szkodzinski","sequence":"additional","affiliation":[{"name":"Third Department of Cardiology, Silesian Center for Heart Disease, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 41-800 Zabrze, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4789-2072","authenticated-orcid":false,"given":"Han","family":"Naung Tun","sequence":"additional","affiliation":[{"name":"Research and Clinical Working Groups, European Society of Cardiology, 06-903 Sophia Antipolis, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8670-8581","authenticated-orcid":false,"given":"Barbara","family":"Zubelewicz-Szkodzinska","sequence":"additional","affiliation":[{"name":"Department of Nutrition Related Prevention, Faculty of Health Sciences in Bytom, Medical University of Silesia, 41-900 Bytom, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,12,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2045","DOI":"10.1161\/ATVBAHA.108.179705","article-title":"Inflammation in atherosclerosis","volume":"32","author":"Libby","year":"2012","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1007\/s11883-017-0678-6","article-title":"Oxidative Stress in Atherosclerosis","volume":"19","author":"Kattoor","year":"2017","journal-title":"Curr. Atheroscler. Rep."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1016\/j.freeradbiomed.2012.05.027","article-title":"Actions of \u201cantioxidants\u201d in the protection against atherosclerosis","volume":"53","author":"Lonn","year":"2012","journal-title":"Free Radic. Biol. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1154","DOI":"10.1038\/ajh.2009.158","article-title":"Blood glutathione and subclinical atherosclerosis in African men: The SABPA Study","volume":"22","author":"Schutte","year":"2009","journal-title":"Am. J. Hypertens."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1016\/j.cca.2017.11.026","article-title":"Gamma-glutamyl transferase and the risk of atherosclerosis and coronary heart disease","volume":"476","author":"Ndrepepa","year":"2018","journal-title":"Clin. Chim. Acta"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"706","DOI":"10.12659\/MSM.890245","article-title":"Serum gamma-glutamyl transferase: A novel biomarker for coronary artery disease","volume":"20","author":"Mao","year":"2014","journal-title":"Med. Sci. Monit."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1007\/s12471-017-0964-5","article-title":"Association of serum gamma-glutamyltransferase and premature coronary artery disease","volume":"25","author":"Sheikh","year":"2017","journal-title":"Neth. Heart J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1002\/clc.22307","article-title":"The relationship between gamma-glutamyl transferase levels and coronary plaque burdens and plaque structures in young adults with coronary atherosclerosis","volume":"37","author":"Celik","year":"2014","journal-title":"Clin. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.atherosclerosis.2014.09.028","article-title":"b-Gamma-glutamyltransferase activity in human vulnerable carotid plaques","volume":"237","author":"Pucci","year":"2014","journal-title":"Atherosclerosis"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/s11154-017-9424-1","article-title":"The vitamin D deficiency pandemic: Approaches for diagnosis, treatment and prevention","volume":"18","author":"Holick","year":"2017","journal-title":"Rev. Endocr. Metab. Disord."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1016\/j.ecl.2017.07.001","article-title":"Biology and Mechanisms of Action of the Vitamin D Hormone","volume":"46","author":"Pike","year":"2017","journal-title":"Endocrinol. Metab. Clin. N. Am."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"4445","DOI":"10.1016\/j.ijcard.2013.06.151","article-title":"Vitamin D serum levels are associated with cardiovascular outcome in coronary artery disease","volume":"168","author":"Siasos","year":"2013","journal-title":"Int. J. Cardiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1016\/j.hjc.2018.06.014","article-title":"Vitamin D deficiency and cardiovascular disease: Fact or fiction?","volume":"59","author":"Tousoulis","year":"2018","journal-title":"Hell. J. Cardiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.1016\/j.jacc.2011.07.008","article-title":"Vitamin D and cardiovascular disease will it live up to its hype?","volume":"58","author":"Lavie","year":"2011","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_15","first-page":"1546","article-title":"Vitamin D supplementation for cardiovascular disease prevention","volume":"306","author":"Lavie","year":"2011","journal-title":"JAMA"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1016\/j.bbadis.2017.01.001","article-title":"Vitamin D in liver disease: Current evidence and potential directions","volume":"4","author":"Elangovan","year":"2017","journal-title":"Biochim. Biophys. Acta Mol. Basis Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1007\/s00380-018-1182-9","article-title":"Mean platelet volume is associated with serum 25-hydroxyvitamin D concentrations in patients with stable coronary artery disease","volume":"33","author":"Hudzik","year":"2018","journal-title":"Heart Vessel."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"3021","DOI":"10.1093\/eurheartj\/ehy339","article-title":"2018 ESC\/ESH Guidelines for the management of arterial hypertension","volume":"39","author":"Williams","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1093\/eurheartj\/ehz455","article-title":"2019 ESC\/EAS Guidelines for the management of dyslipidaemias: Lipid modification to reduce cardiovascular risk","volume":"41","author":"Mach","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1093\/eurheartj\/ehz486","article-title":"2019 ESC Guidelines on diabetes, pre-diabetes, and cardiovascular diseases developed in collaboration with the EASD","volume":"41","author":"Cosentino","year":"2020","journal-title":"Eur. Heart J."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Boettger, S.F., Angersbach, B., Klimek, C.N., Wanderley, A.L.M., Shaibekov, A., Sieske, L., Wang, B., Zuchowski, M., Wirth, R., and Pourhassan, M. (2018). Prevalence and predictors of vitamin D-deficiency in frail older hospitalized patients. BMC Geriatr., 18.","DOI":"10.1186\/s12877-018-0919-8"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e77","DOI":"10.1111\/jgs.14566","article-title":"Oxidized LDL, Gamma-Glutamyltransferase and Adverse Outcomes in Older Adults","volume":"65","author":"Spoto","year":"2017","journal-title":"J. Am. Geriatr Soc."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"98","DOI":"10.3343\/alm.2014.34.2.98","article-title":"Mean platelet volume and vitamin D level","volume":"34","author":"Cure","year":"2014","journal-title":"Ann. Lab. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1161\/01.CIR.0000120558.41356.E6","article-title":"Images in cardiovascular medicine. Human atherosclerotic plaques contain gamma-glutamyl transpeptidase enzyme activity","volume":"109","author":"Paolicchi","year":"2004","journal-title":"Circulation"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1080\/20014091084227","article-title":"Gamma glutamyl transferase","volume":"38","author":"Whitfield","year":"2001","journal-title":"Crit. Rev. Clin. Lab. Sci."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"7109","DOI":"10.3748\/wjg.v11.i45.7109","article-title":"Associations between gamma-glutamyl transferase, metabolic abnormalities and inflammation in healthy subjects from a population-based cohort: A possible implication for oxidative stress","volume":"11","author":"Bo","year":"2005","journal-title":"World J. Gastroenterol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2078","DOI":"10.1161\/CIRCULATIONAHA.105.571919","article-title":"Gamma-glutamyltransferase, atherosclerosis, and cardiovascular disease: Triggering oxidative stress within the plaque","volume":"112","author":"Emdin","year":"2005","journal-title":"Circulation"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1093\/oxfordjournals.aje.a117699","article-title":"Gamma-glutamyltransferase: Determinants and association with mortality from ischemic heart disease and all causes","volume":"142","author":"Wannamethee","year":"1995","journal-title":"Am. J. Epidemiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"3798","DOI":"10.1074\/jbc.M008484200","article-title":"Expression of gamma-glutamyl transpeptidase protects ramos B cells from oxidation-induced cell death","volume":"276","author":"Karp","year":"2001","journal-title":"J. Biol. Chem."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1002\/clc.20345","article-title":"The importance of gamma-glutamyltransferase activity in patients with coronary artery disease","volume":"32","author":"Demircan","year":"2009","journal-title":"Clin. Cardiol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1802","DOI":"10.1053\/euhj.2001.2807","article-title":"Prognostic value of serum gamma-glutamyl transferase activity after myocardial infarction","volume":"22","author":"Emdin","year":"2001","journal-title":"Eur. Heart J."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1177\/0003319711431880","article-title":"The prognostic value of serum gamma glutamyl transferase activity on admission in patients with STEMI undergoing primary PCI","volume":"63","author":"Akpek","year":"2012","journal-title":"Angiology"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1097\/MCA.0b013e32834e4ed0","article-title":"Gamma-glutamyltransferase in acute coronary syndrome patients without ST elevation and its association with stenotic lesion and cardiac events","volume":"23","author":"Dogan","year":"2012","journal-title":"Coron. Artery Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2429160","DOI":"10.1155\/2018\/2429160","article-title":"Gamma-Glutamyltransferase and Risk of Acute Coronary Syndrome in Young Chinese Patients: A Case-Control Study","volume":"2018","author":"Huang","year":"2018","journal-title":"Dis. Markers"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1016\/j.atherosclerosis.2015.06.034","article-title":"Vitamin D for the prevention of cardiovascular disease: Are we ready for that?","volume":"241","author":"Carvalho","year":"2015","journal-title":"Atherosclerosis"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1038\/nrcardio.2016.73","article-title":"Vitamin D and cardiovascular disease prevention","volume":"13","author":"Pilz","year":"2016","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1056\/NEJMoa1809944","article-title":"Vitamin D Supplements and Prevention of Cancer and Cardiovascular Disease","volume":"380","author":"Manson","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"608","DOI":"10.1001\/jamacardio.2017.0175","article-title":"Effect of Monthly High-Dose Vitamin D Supplementation on Cardiovascular Disease in the Vitamin D Assessment Study: A Randomized Clinical Trial","volume":"2","author":"Scragg","year":"2017","journal-title":"JAMA Cardiol."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Barchetta, I., Angelico, F., Del Ben, M., Baroni, M.G., Pozzilli, P., Morini, S., and Cavallo, M.G. (2011). Strong association between non alcoholic fatty liver disease (NAFLD) and low 25(OH) vitamin D levels in an adult population with normal serum liver enzymes. BMC Med., 9.","DOI":"10.1186\/1741-7015-9-85"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2915","DOI":"10.1017\/S1368980020000348","article-title":"Low serum 25-hydroxyvitamin D levels are associated with liver injury markers in the US adult population","volume":"23","author":"He","year":"2020","journal-title":"Public Health Nutr."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Barchetta, I., Cimini, F.A., and Cavallo, M.G. (2017). Vitamin D Supplementation and Non-Alcoholic Fatty Liver Disease: Present and Future. Nutrients, 9.","DOI":"10.3390\/nu9091015"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Barchetta, I., Del Ben, M., Angelico, F., Martino, M.D., Fraioli, A., Torre, G.L., Saulle, R., Perri, L., Morini, S., and Tiberti, C. (2016). No effects of oral vitamin D supplementation on non-alcoholic fatty liver disease in patients with type 2 diabetes: A randomized, double-blind, placebo-controlled trial. BMC Med., 14.","DOI":"10.1186\/s12916-016-0638-y"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/j.jsbmb.2017.09.009","article-title":"The relationship between 25-hydroxyvitamin D concentration and liver enzymes in overweight or obese adults: Cross-sectional and interventional outcomes","volume":"177","author":"Naderpoor","year":"2018","journal-title":"J. Steroid Biochem. Mol. Biol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1016\/j.dsx.2018.03.006","article-title":"Vitamin D supplementation for the treatment of non-alcoholic fatty liver disease: A randomized double blind placebo controlled trial","volume":"12","author":"Dabbaghmanesh","year":"2018","journal-title":"Diabetes Metab. Syndr."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Barchetta, I., Cimini, F.A., and Cavallo, M.G. (2020). Vitamin D and Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD): An Update. Nutrients, 12.","DOI":"10.3390\/nu12113302"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"R25","DOI":"10.1530\/JOE-13-0201","article-title":"Inflammation as a potential link between nonalcoholic fatty liver disease and insulin resistance","volume":"218","author":"Asrih","year":"2013","journal-title":"J. Endocrinol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"727","DOI":"10.3748\/wjg.v18.i8.727","article-title":"Role of cytokines and chemokines in non-alcoholic fatty liver disease","volume":"18","author":"Braunersreuther","year":"2012","journal-title":"World J. Gastroenterol."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e983401","DOI":"10.4161\/19381980.2014.983401","article-title":"Vitamin D and inflammation","volume":"6","author":"Cannell","year":"2014","journal-title":"Dermatoendocrinology"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"803","DOI":"10.1007\/s00011-014-0755-z","article-title":"Inflammation and vitamin D: The infection connection","volume":"63","author":"Mangin","year":"2014","journal-title":"Inflamm. Res."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/23\/8980\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:40:46Z","timestamp":1760179246000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/23\/8980"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,2]]},"references-count":49,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2020,12]]}},"alternative-id":["ijerph17238980"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17238980","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,2]]}}}