We aimed to investigate the association of GGT variability with venous thromboembolism (VT).

Gamma-glutamyl transferase (GGT) is involved in inflammation, stroke, and atrial fibrillation.

Data from the NHIS-HEALS database of participants who underwent health examination between 2003 and 2008 were included (n=1,085,105). Variability indexes were (1) coefficient of variation (CV), (2) standard deviation (SD), and (3) variability independent of the mean (VIM). Occurrence of VT was defined as two or more claims of one of the following ICD-10 codes: deep VT (I80.2–80.3), pulmonary thromboembolism (I26, I26.0, I26.9), intraabdominal thrombosis (I81, I82, I82.2, I82.3), or other VT (I82.8, I82.9).

During the median 12.4 (interquartile range 12.2 – 12.6) years of analysis, VT occurred in 11,769 (1.08%) patients. The GGT level was measured a total of 5,707,768 times in this study. In multivariable analysis, quartiles of GGT variability verified with CV positively correlated with the occurrence of VT (adjusted hazard ratio (HR) (highest quartile compared with the lowest quartile) 1.15, 95% confidence interval (CI) 1.09-1.21, p < 0.001). This trend was consistent even when GGT variability was applied to SD (adjusted HR (highest quartile compared with the lowest quartile) 1.24, 95% CI 1.17-1.31, p < 0.001) and VIM (adjusted HR (highest quartile compared with the lowest quartile) 1.10, 95% CI 1.05-1.16, p < 0.001).

Increased GGT variability may be associated with an increased risk of VT. Maintaining stable GGT level would be helpful in reducing the risk of VT.