{
  "abstract": "Background Serum Gamma-Glutamyl Transferase (GGT) is a well-established marker of oxidative stress and hepatobiliary dysfunction. While its association with metabolic syndrome and liver disease is known, its specific prognostic value for pancreatic pathology remains understudied. We aimed to evaluate the association between elevated serum GGT and the 3-year risk of pancreatic cysts, pancreatic cancer, all-cause mortality, and hospitalization in a large, multi-center US cohort.Methods We conducted a cohort study using the TriNetX database. Adult patients (≥18 years) were stratified by sex and serum GGT levels: High GGT (Males >57 U/L; Females >26 U/L) and Low GGT (Males <23 U/L; Females <14 U/L). Patients with a history of pancreatic disease (acute/chronic pancreatitis, cysts, or neoplasms) within 1 year of the index event were excluded. We performed 1:1 propensity score matching (PSM) to balance cohorts for age, race, ethnicity, BMI, and key comorbidities (hypertension, diabetes, CKD, alcohol use, ­smoking). The primary outcomes were the 3-year risk of pancreatic cyst (ICD-10 K86.2) and pancreatic cancer (ICD-10 C25). Secondary outcomes included all-cause mortality and inpatient hospitalization.Results After matching, the study included 41,484 patients (25,130 males; 16,354 females). Baseline characteristics were well-balanced (SMD < 0.1).In the male cohort (n=12,565 per group), high GGT was strongly associated with incident pancreatic cancer (0.8% vs. 0.2%; HR 4.39 [95% CI, 2.76–6.98]; p<0.001) and pancreatic cysts (0.4% vs. 0.2%; HR 1.92 [1.22–3.03]; p=0.004). High GGT males also had significantly higher rates of all-cause mortality (14.8% vs. 5.8%; HR 2.67 [2.45–2.91]; p<0.001) and hospitalization (31.6% vs. 22.3%; HR 1.55 [1.47–1.62]; p<0.001).In the female cohort (n=8,177 per group), high GGT was significantly associated with incident pancreatic cysts (0.4% vs. 0.2%; HR 1.96 [1.11–3.46]; p=0.018). High GGT females also exhibited a threefold increase in all-cause mortality (8.6% vs. 2.6%; HR 3.37 [2.89–3.93]; p<0.001) and increased risk of hospitalization (27.8% vs. 19.0%; RR 1.47 [1.39–1.55]; p<0.001).Conclusions Elevated serum GGT is an independent predictor of developing pancreatic cysts and pancreatic cancer, particularly in males, where it confers a four-fold increased risk of malignancy. Furthermore, high GGT levels identify a phenotype at significantly higher risk for all-cause mortality and hospitalization across both sexes.",
  "authors": [
    {
      "affiliations": [
        "Sheffield Teaching Hospitals NHS Foundation Trust, United Kingdom"
      ],
      "name": "Arkadeep Dhali"
    },
    {
      "affiliations": [
        "Roswell Park Comprehensive Cancer Center, United States"
      ],
      "name": "Fayaz Khan"
    }
  ],
  "title": "IDDF2026-ABS-0330 Elevated serum gamma-glutamyl transferase (GGT) is a significant predictor of pancreatic cyst, pancreatic cancer, and mortality: a propensity-matched analysis of 41,484 patients",
  "uid": "5e8745f5-2ea1-5214-b852-d1e0da6793c6"
}