Tehran University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share this content! On (X network) By
The Association Between Serum Gamma-Glutamyl Transferase and Gastrointestinal Cancer Risk: A Systematic Review and Meta-Analysis Publisher Pubmed



Ramandi A1, 2 ; George J3 ; Behnoush AH2 ; Delavari A4 ; Mohammadi Z4 ; Poustchi H4 ; Malekzadeh R2, 4
Authors
Show Affiliations
Authors Affiliations
  1. 1. Division of Gastroenterology and Hepatology, Weill Cornell Medicine, New York, NY, United States
  2. 2. Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran
  3. 3. Storr Liver Centre, Westmead Institute for Medical Research, Westmead Hospital and University of Sydney, Westmead, NSW, Australia
  4. 4. Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran

Source: Cancer Medicine Published:2025


Abstract

Background: Gamma-glutamyl transferase (GGT) has been shown to have associations with several diseases including cancers. Previous studies have investigated the effect of GGT levels on the gastrointestinal (GI) cancer incidence. We aim to systematically investigate these studies to provide better insights into the interrelationship between GGT and GI cancers. Methods: Online databases were searched to find relevant studies investigating different GGT levels' effects on the incidence of GI cancers including colorectal, esophageal, liver, pancreas, gastric, and biliary duct cancers. Random-effect meta-analysis was conducted to pool the hazard ratios (HRs) of GGT quartiles (Qs) effect on cancer incidence. Results: A total of 26 studies were included in the final review, 12 of which underwent meta-analysis that investigated 11 million patients. Based on the meta-analysis, Q4 patients had a 69% higher hazard of GI cancer incidence (HR 1.69, 95% CI 1.41–2.02, p-value < 0.001). The hazard ratio significance was also similar for Q3 (HR 1.22, 95% CI 1.15–1.30, p-value < 0.001) and Q2 (HR 1.10, 95% CI 1.05–1.16, p-value =0.002) of GGT. Colorectal and liver cancers showed a higher hazard ratio among Q2, Q3, and Q4 of GGT compared to Q1. In pancreas and bile duct cancers, only Q4 of GGT had significantly higher HR. Q3 and Q4 of GGT levels had statistically significant associations with gastric cancer incidence. Conclusion: Higher GGT levels correlate with higher rates of GI cancer incidence, especially in colorectal and hepatic cancers. Future studies should investigate this biomarker's potential role in risk assessment for digestive cancers. © 2025 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.
Related Docs
View other Related Docs
1. Elevated Liver Enzymes and Cardiovascular Mortality: A Systematic Review and Dose-Response Meta-Analysis of More Than One Million Participants, European Journal of Gastroenterology and Hepatology (2019)
2. The Effects of Conjugated Linoleic Acid Supplementation on Inflammatory Cytokines and Adipokines in Adults: A Grade-Assessed Systematic Review and Dose–Response Meta-Analysis, Frontiers in Immunology (2023)
3. What Is the Influence of Cinnamon Supplementation on Liver Enzymes? a Systematic Review and Meta-Analysis of Randomized Controlled Trials, Phytotherapy Research (2021)
4. A Systematic Review and Meta-Analysis of Convolutional Neural Network in the Diagnosis of Colorectal Polyps and Cancer, Turkish Journal of Gastroenterology (2023)
5. Prevalence of Depression in Older People With Hip Fracture: A Systematic Review and Meta-Analysis, International Journal of Orthopaedic and Trauma Nursing (2021)
6. Tea Consumption and Gastric Cancer: A Pooled Analysis From the Stomach Cancer Pooling (Stop) Project Consortium, British Journal of Cancer (2022)
7. The Effects of Astaxanthin Supplementation on Liver Enzyme Levels: A Systematic Review and Meta-Analysis, International Journal for Vitamin and Nutrition Research (2024)
8. Unravelling the Challenge of Cotrimoxazole and Rifampin Resistance in B. Melitensis and B. Abortus: A Systematic Review and Metaanalysis, PLoS Neglected Tropical Diseases (2024)
Experts (# of related papers)
View all Related Experts
Reza Malekzadeh (4)
Hossein Poustchi (3)
Other Related Docs
9. Effects of Artichoke Leaf Extract Supplementation or Artichoke Juice Consumption on Lipid Profile: A Systematic Review and Dose–Response Meta-Analysis of Randomized Controlled Trials, Phytotherapy Research (2021)
10. Evaluation of Serum and Plasma Interleukin-6 Levels in Obstructive Sleep Apnea Syndrome: A Meta-Analysis and Meta-Regression, Frontiers in Immunology (2020)
11. The Effect of Acarbose on Inflammatory Cytokines and Adipokines in Adults: A Systematic Review and Meta-Analysis of Randomized Clinical Trials, Inflammopharmacology (2024)
12. The Effects of Lifestyle Modifications Including Dietary and Physical Interventions With Cognitive-Behavioral Therapy on Quality of Life and Cancer-Recurrence Rate Among Patients With Breast Cancer and Survivors: A Protocol for a Systematic Review and Meta-Analysis of Randomized Controlled Trial, International Journal of Cancer Management (2020)
13. The Relation Between Obesity and Breast Cancer Risk in Women by Considering Menstruation Status and Geographical Variations: A Systematic Review and Meta-Analysis, BMC Women's Health (2023)
14. Neighbourhood Socioeconomic Status and Overweight/Obesity: A Systematic Review and Meta-Analysis of Epidemiological Studies, BMJ Open (2019)
15. Association Between Alcohol Consumption and Chronic Pain: A Systematic Review and Meta-Analysis, British Journal of Anaesthesia (2022)
16. Investigating the Role of Circulating Tumor Cells in Gastric Cancer: A Comprehensive Systematic Review and Meta-Analysis, Clinical and Experimental Medicine (2024)
17. Prognostic Significance of Matrix Metalloproteinase-7 in Gastric Cancer Survival: A Meta-Analysis, PLoS ONE (2015)
18. Assessment of Genetic Aspects of Non-Alcoholic Fatty Liver and Premature Cardiovascular Events, Middle East Journal of Digestive Diseases (2020)
19. Preventive Effects of a Cvd Polypill on Developing Diabetes Among Patients With Metabolic Syndrome: Results of the Polyiran-Liver Trial, Archives of Iranian Medicine (2024)
20. Evaluation of Blood Levels of C-Reactive Protein Marker in Obstructive Sleep Apnea: A Systematic Review, Meta-Analysis and Meta-Regression, Life (2021)
21. Automated Diagnosis of Autism With Artificial Intelligence: State of the Art, Reviews in the Neurosciences (2024)
22. The Effects of Conjugated Linoleic Acid Supplementation on Liver Function Enzymes and Malondialdehyde in Adults: A Grade-Assessed Systematic Review and Dose-Response Meta-Analysis, Pharmacological Research (2022)
23. Association of Serum Gamma-Glutamyltransferase and Premature Coronary Artery Disease, Netherlands Heart Journal (2017)
24. Comparison of the Effect of a Low-Carbohydrate Diet With a Low-Fat Diet on Anthropometric Indices and Body Fat Percentage: A Systematic Review and Meta-Analysis of Randomized Controlled Trials, Journal of Nutrition and Food Security (2023)
25. Heart Failure With Preserved Ejection Fraction and Atrial Fibrillation: Catheter Ablation Vs. Standard Medical Therapy — a Systematic Review and Meta-Analysis, Heart Failure Reviews (2025)
26. Polypill Protects Mafld Patients From Cardiovascular Events and Mortality: A Prospective Trial, Hepatology International (2023)
27. Effect of Orlistat on Serum Uric Acid Level in Adults: A Systematic Review and Meta-Analysis of Randomised Controlled Trials, International Journal of Clinical Practice (2021)
28. Effect of Zinc Supplementation in the Management of Type 2 Diabetes: A Grading of Recommendations Assessment, Development, and Evaluation-Assessed, Dose-Response Meta-Analysis of Randomized Controlled Trials, Critical Reviews in Food Science and Nutrition (2023)
29. Is Leukocyte Telomere Length Related With Lung Cancer Risk?: A Meta-Analysis, Iranian Biomedical Journal (2017)
30. Global Prevalence of Macrolide-Resistant Staphylococcus Spp.: A Comprehensive Systematic Review and Meta-Analysis, Frontiers in Microbiology (2025)
31. Association of Dietary Nitrate, Nitrite, and N-Nitroso Compounds Intake and Gastrointestinal Cancers: A Systematic Review and Meta-Analysis, Toxics (2023)
32. Comparison Between Clevidipine and Nicardipine in Cerebrovascular Diseases: A Systematic Review and Meta-Analysis, Clinical Neurology and Neurosurgery (2023)
33. Determinants of Parathyroid Hormone Response to Vitamin D Supplementation: A Systematic Review and Meta-Analysis of Randomised Controlled Trials, British Journal of Nutrition (2015)
34. Association Between Occupational Noise Exposure and Diabetes: A Systematic Review and Meta-Analysis, International Journal of Hygiene and Environmental Health (2023)
35. The Effects of Hesperidin Supplementation on Cardiovascular Risk Factors in Adults: A Systematic Review and Dose–Response Meta-Analysis, Frontiers in Nutrition (2023)
36. What Does My Neighbourhood Have to Do With My Weight? a Protocol for Systematic Review and Meta-Analysis of the Association Between Neighbourhood Socioeconomic Status and Body Weight, BMJ Open (2017)
37. The Effect of Nigella Sativa on the Measures of Liver and Kidney Parameters: A Systematic Review and Meta-Analysis of Randomized-Controlled Trials, Pharmacological Research (2020)
38. The Association Between Zinc and Prostate Cancer Development: A Systematic Review and Meta-Analysis, PLoS ONE (2024)
39. The Effect of Personalized Intelligent Digital Systems for Self-Care Training on Type Ii Diabetes: A Systematic Review and Meta-Analysis of Clinical Trials, Acta Diabetologica (2023)
40. Recurrence of Arthroscopic Treatment of Pigmented Villonodular Synovitis of the Knee: A Systematic Review and Meta-Analysis, Journal of Experimental Orthopaedics (2025)
41. Prevalence of Metabolic Syndrome Among Iranian Population: A Systematic Review and Meta-Analysis, Iranian Journal of Public Health (2017)
42. Ultra-Processed Food and the Risk of Overweight and Obesity: A Systematic Review and Meta-Analysis of Observational Studies, International Journal of Obesity (2020)
43. Prevalence of Antibiotic-Resistant Cutibacterium Acnes (Formerly Propionibacterium Acnes) Isolates, a Systematic Review and Meta-Analysis, Journal of Global Antimicrobial Resistance (2024)
44. The Carcinogenicity of Opium Consumption: A Systematic Review and Meta-Analysis, European Journal of Epidemiology (2023)
45. Association Between Elmo1 Gene Polymorphisms and Diabetic Kidney Disease: A Systematic Review and Meta-Analysis, PLoS ONE (2024)
46. Serum and Plasma Tumor Necrosis Factor Alpha Levels in Individuals With Obstructive Sleep Apnea Syndrome: A Meta-Analysis and Meta-Regression, Life (2020)