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Santa Clarita Sand Fire
On July 23, 2016, Santa Clarita was hit with the devastating Sand Fire that spread rapidly and called for an urgent evacuation of thousands of homes, people and their animals. Many animal sanctuaries and horse owners had to evacuate because the fire was quickly approaching. As the wind changed directions, so did the fire and it headed straight towards The Monte Verde Ranch and their 140 horses, along with The Wildlife Way Station, who's 450 wild and exotic animals had to be safely evacuated. Just a few of the many sanctuaries who had to evacuate all of their rescued animals.
As the fire continued to grow and more animals were in desperate need of evacuation, colleges, sanctuaries, animal control centers and shelters began opening their doors and allowing animals who needed temporary homes to be boarded at their facilities, ensuring their safety.
After several daunting days, the fire was 100% contained, leaving 38,346 acres of land that burned in its path. The animals who were brought to temporary boarding facilities have been transported back home safely.
For Animal Evacuation and Disaster Relief Updates
PLEASE VISIT: www.WorldAnimalNews.com
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Baby Elephant Dies At Ringling Bros. Breeding Center
POLK CITY, FL – Mike, the youngest elephant resident at Ringling Bros. & Barnum Bailey Center for Elephant Conservation (a breeding center) in Polk City, has died from the elephant endotheliotropic herpesvirus (EEHV).
Final necropsy results are in progress, but officials preliminary results along with blood tests suggest that the virus was the cause of death.
Dr. Ashley Settles, the director of Ringling Bros. veterinary care: "No one knows why the virus manifests this way in some elephants, since most elephants harbor the virus and never become ill. Mike only began to show the slightest of symptoms on Saturday and was eating and drinking well as late as Sunday afternoon, but the illness progressed very rapidly. As soon as symptoms began we started treating him, but by Monday morning there was nothing more anyone could do to prevent his passing."
The elephant was born at the breeding center on June 27, 2013 to parents also born there. Mike was the first elephant to die of EEHV at the center, which has experienced 26 endangered Asian elephant births since 1995.
The Center for Elephant Conservation (CEC) is a 200-acre breeding farm and retirement facility for elephants that is sponsored by Feld Entertainment, the holding company and owner of Ringling Brothers and Barnum and Bailey Circus. The CEC is the largest Asian elephant gene pool outside of Southeast Asia. The center failed a USDA inspection under the Animal Welfare Act due to its restraint policy in 1999. At least one case of TB was noted during the inspection.
Sources: Wiki
www.clickorlando.com
Photos: Newsweek
http://365thingsswfl.com
WFTF TV
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Breaking News! Thai Authorities Remove 5 Tigers From Infamous Tiger Temple
The first five of 147 tigers have been removed from the infamous Tiger Temple in Kanchanaburi by the Department of National Parks, according to Wildlife Friends Foundation Thailand. This development sends a clear message to the rest of the world that the Thai government is serious about protecting its tigers, which sets an essential precedent.
"The exploitation, illegal trade and torture is going to stop," the foundation said in a post.
The controversial, but popular tourist temple, which brings $3 million dollars annually due to tourists visiting to play and take selfies with the animals, has long been accused of abusing and exploiting their tigers.
Last week, National Geographic magazine stated that it had uncovered evidence that the infamous temple was trafficking the tigers and selling them on the black market.
The tigers were tranquilized and transported to government-operated animal reserves in Ratchaburi, according to the Bangkok Post.
Although this seems promising, there are also rumors abound that the government has agreed to only remove 70 tigers, while the remaining 77 will be taken to a new zoo currently under construction. The logistics will need to be determined as far as the tigers' path to freedom.
Past efforts to retrieve animals from the temple literally took an army. In April 2015, a team of 400, made up of department staff, soldiers, and police acted together to retrieve several moon bears kept without permits from the temple. More than 100 monks and staff blocked the entrance, which led the team to resort to hoisting the animals out with a crane.
If there is no similar resistance, 5-10 of the 140 tigers could be rescued and transported out of the temple per day. The hope is that they will then be housed in a true sanctuary.
Despite overwhelming evidence against the Tiger Temple, thousands of tourists continue to line up for selfies, which fuels the illegal tiger trade.
Sources: One Green Planet
Coconut Bangkok
Photo: Coconut Bangkok
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Two Young Gorillas Dismantle Poachers' Traps After Death Of Fellow Gorilla
RWANDA-Researchers have observed two four-year old gorillas working together to dismantle snares within Rwanda's Volcanoes National Park a few days after a poacher's trap killed a fellow mountain gorilla in the same area.
Veronica Vecellio from the Dian Fossey Gorilla Fund's Karisoke Research Centre in Rwanda: "This is absolutely the first time that we've seen juveniles doing that … I don't know of any other reports in the world of juveniles destroying snares. We are the largest database and observer of wild gorillas … so I would be very surprised if somebody else has seen that."
Gorillas are not the intended victims, as thousands of snares are set up by local bush meat hunters who are attempting to catch antelopes and other animals.
The traps, hidden by dry leaves and branches, operate by tying a noose to a branch of bamboo stalk, and bending it down to the ground, while another stick or rock is used to hold the noose in place.
If an animal moves the anchoring rock or stick, the branch will fling back up and tighten the noose around it, holding the captive in place until the poachers arrive, even possibly hoisting the captured animal into the air.
Young gorillas often are not able to free themselves, and run a huge risk of succumbing to injuries caused during their escape.
The worrisome fact is that the population cannot sustain these losses.
A tracker, John Ndayambaje, attempted to dismantle the snare, but was given a warning signal by the dominant male of the clan indicating that he wanted him to stop.
Ker Than of National Geographic: "Suddenly two juveniles – Rwema, a male; and Dukore, a female; both about four years old – ran toward the trap. As Ndayambaje and a few tourists watched, Rwema jumped on the bent tree branch and broke it, while Dukore freed the noose."
The two gorillas then reportedly located another snare, and with the assistance of another juvenile, managed to dismantle it as well. Researchers suspect that the confidence and speed with which the gorillas destroyed the traps means they had educated themselves on the dangerous nature of the contraptions, and have most likely dismantled them previously. They have stated that they will not interfere with the gorillas' behavior and hope they will teach the rest of their clan to disable the traps as well.
Source: Science Alert
Photo: Morgan Trimble
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LCA Investigation At Marineland Canada Reveals Cruelty To Whales
LCA Trunk conducted a five-month undercover investigation into Marineland Canada, wholesale nba jerseys during the summer and Advocate fall of 2015, with a primary focus on UnChained: the park's beluga whale population and Sonakull the Lee conditions under cheap mlb jerseys which they are being held. The majority of the park's 46 belugas are confined to just three main pools with no breeding program in place cheap nba jerseys to regulate births, allowing Marineland's population of belugas to continue to grow at an cheap nba jerseys alarming Trophy and irresponsible rate.
The investigation uncovered disturbing inadequacies in the care of the whales, which include:
-Multiple beluga cows observed suffering for months from an undiagnosed condition reported by employees to park management as "genital rubbing" which caused the whales to rub themselves constantly against the concrete tank until blood was visible in the water
-Gia, a juvenile beluga who was initially separated from her mother by accident, was left in a shallow isolation pool for three months while she became emaciated
-A three-month old beluga calf with a deep laceration near his fluke left untreated for two days before seen by a local small animal vet. The laceration reopened shortly thereafter
-Belugas exhibiting signs of eye abnormalities, such as redness, irritation, and cataracts, and in some cases, young belugas appearing to develop cataracts prematurely
-Numerous belugas with various medical conditions, such as hypersalivation, regurgitation, and raw, red throats, in some cases for prolonged periods of time
-Routine deprivation of food for training purposes
-The birth of 5 calves, one of which died
The investigation also revealed that the whales were housed in enclosures that are not only barren in comparison to their natural environment but also unsafe and harmful in their very design and the interactions they promote, including:
-46 belugas of both sexes ranging in age from newborns to mature adults confined in three main cement enclosures
-Belugas, including newborn calves, covered in "rake marks", from being attacked and bitten by dominant whales
-Enclosures that did not provide the whales with areas away from public view, nor any protection from the elements
-Enclosures with inadequate barriers that promote unsupervised public contact with the whales as well as the accidental or deliberate introduction of foreign objects into the whales' enclosures
-Kiska, Marineland's lone orca, constantly swimming in circles in the smaller of her two pools
-More than 100 barrels of industrial strength bleach kept on site, and employees repeatedly complaining of burning eyes and a strong chlorine smell on certain days when next to the pools
These findings formed the basis of LCA's complaint to the Ontario Society for the Prevention of Cruelty to Animals for violations of the OSPCA Act and its prescribed standards of care.
Marineland Canada, located in Niagara Falls, Ontario, first opened its doors in 1961 as little more than a roadside attraction.
John Holer, whose background is in the circus industry, purchased three sea lions to put on display, and charged one quarter for admission.
From that point forward, the park began growing rapidly, and by the 1970's, had expanded to include a 2,000 seat "aquatheatre", as well as acquiring its first captive orca, "Kandu", who quickly became the star attraction. Marineland is now not only Canada's largest amusement park, but also confines more beluga whales than any other park in the world.
Marineland and Mr. Holer are no strangers to controversy, having become the subject of intense public scrutiny after allegations emerged of mass animal graves located inside the park, a claim which was later proven to be true.
Since then, the park has been involved in a litany of scandals involving both the park itself, and the often erratic behavior of its owner, John Holer. Persistent pressure and condemnation from the public, activists, and particularly from former Marineland employees themselves have garnered widespread media coverage, including an in-depth investigation into the park by The Toronto Star.
Despite Marineland management and Mr. Holer's repeated attempts to silence critics with frivolous lawsuits and threats of litigation, the atrocities committed by Marineland and Mr. Holer are firmly established in public's eye.
LCA's investigation reveals that no whales should be kept in captivity and that doing so causing suffering and distress to these sensitive social creatures. Canadian parliament has before it bill S-203, "Ending the Captivity of Whales and Dolphins Act" which would prevent this tragedy being inflicted upon future whales by banning their capture, confinement, breeding and sale.
CLICK HERE to sign the petition to Senator Moore supporting Follow bill S-203!!
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https://peace4animals.net/wp-content/uploads/2016/08/logo.jpg 0 0 admin https://peace4animals.net/wp-content/uploads/2016/08/logo.jpg admin2016-02-02 18:20:042017-02-06 13:00:01LCA Investigation At Marineland Canada Reveals Cruelty To Whales
Dolphin Advocate Ric O'Barry Still Detained In Japan As Political Prisoner
American dolphin advocate Ric O'Barry has been detained in Japan since he was denied entry into the country on January 18th. He has stated that he is being targeted due to his efforts to save the dolphins from the tragic Taiji hunts. O'Barry faces deportation.
"I'm a political prisoner. I think there are higher-ups in government who are cracking down on those who speak out against their war on dolphins," O'Barry told Reuters via telephone from an immigration lock-up located close to Tokyo's Narita airport.
O'Barry and his lawyer state that he is being accused of being dishonest to officials about the nature of his activities during a previous trip to the country.
"Never once have I broken the law, never once have I lied to immigration," O'Barry said.
The Taiji hunt has become an international concern for animal welfare advocates since the Oscar-winning documentary film The Cove exposed the tragic and bloody dolphin hunts in Taiji.
Ric O'Barry's wife Helene Hesselager O'Barry has posted a plea for her husband on his Dolphin Project site:
January 25, 2016: "For more than one week, my cheap nba jerseys husband, Ric O'Barry, has been incarcerated in a Japanese detention center, after immigration officials refused to allow him entry into the country. The day started off normal enough, and when he was pulled aside for a "routine" interrogation, he wasn't overly concerned. Since cheap jerseys the release of "The Cove", the 2009 Oscar award-winning documentary that exposed the brutal dolphin drives in Taiji, Japan, he has been questioned longer, more aggressively, and often for hours at a time. But nothing like what cheap nba jerseys would transpire that day."
"I am deeply concerned for him, and every day, am contacted by people from all over the world who want to know how he is, and when he will be released. They are shocked at how he has been treated. Why, they ask, when it's a well-known fact that O'Barry has been traveling to Japan for years, and has many friends there. It is a country he loves dearly, always speaking about Japan with tremendous respect for its people. And, while wearing his activist "hat," he always operated fully within Japanese law, making it absolutely clear that his only problem with Japan is the horrendous killing of whales and dolphins that goes on there."
Various celebrities and friends of O'Barry, including Slash and Matt Sorum of Guns N' Roses, Montel Williams, and Queen's Brian May have tweeted in support of Ric's plight.
U.S. ambassador to Japan, Caroline Kennedy, has expressed concern, but has yet to take real action. She recently was photographed with Japanese President Shinzo Abe, which has caused controversy as O'Barry remains detained.
In the past on NBC's Today Show, Caroline Kennedy stood by a controversial tweet that characterized the dolphin hunt as inhumane. The Japanese government called her tweet hypocritical based upon the cruelty within the American meat industry.
"That was a U.S. policy," Kennedy stated. "I hope I'm an effective ambassador, and sometimes that means working behind the scenes and sometimes that means speaking out."
Please CONTACT and politely urge Caroline to take stronger action against the hunts and let her know that the world is behind her and supports tough sanctions against Japan in order to put an END to the annual slaughter. Also, let her know that Ric O'Barry should be released right away and that this is an URGENT matter. He should not be deported.
Twitter: BREAKING: @CarolineKennedy
In Japan:
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Also, you UnChained: may マクタン島にあるディスコ contact other influential members of her family in order to influence the issue to trend within the Kennedy family:
Bobby Shriver @bobbyshriver
Robert Kennedy wholesale jerseys Jr. @RobertKennedyJr Service
SIGN these PETITIONS:
http://www.thepetitionsite.com/takeaction/207/680/249/?z00m=27360048&redirectID=1939937933
https://dolphinproject.net/take-action/release-ric-obarry-from-custody-in-japan/
Main Photo: Scott London
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Jane UnChained: Stop Australia's Live Animal Export Horror!
Watch Jane Velez-Mitchell of Jane UnChained; Katie wholesale MLB jerseys Cleary, founder of World Animal News; Judie Mancuso, founder of Social cheap MLB jerseys Compassion in Legislation; Ginn Andrews of World Animal News; activist Simone Reyes; Amanda Copeland; Services actor Martin Dingle Wall; and Patty Leopard Shenker, co-founder of Upcoming the Animal Advocacy Museum, make an cheap nba jerseys attempt Google to speak to Australian consulate officials to stop Australia's barbaric cheap jerseys live animal export life trade!
#BanLiveExport
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BREAKING: South Africa Bans Leopard Trophy Hunting
The wholesale jerseys China Department cheap mlb jerseys of cheap jerseys Environmental Sports Affairs As has On effectively banned leopard trophy hunting throughout South Africa after it set provincial leopard trophy hunting quotas at zero for 2016.
The number of leopards in the country is unknown, and an urgent alert was sent that trophy hunting posed a high risk to the survival of the species.
Under CITES (Convention on International Trade in Endangered Species of Wild Fauna and Flora), South Africa may allocate 150 leopard trophy export permits annually. A warning appeared in the Government Gazette last year that stated that if the guidelines weren't adhered to, quotas would be set to zero for 2016.
Guy Balme of the environmental NGO Panthera: 'We just don't know how leopards are faring in South Africa. They're secretive, mainly nocturnal, solitary and range over huge areas. Counting them requires intensive research using expensive technology such as camera traps, which can only be deployed over small areas, far smaller than the areas in which hunting quotas are determined. It seems prudent that hunting should only continue once the appropriate measures are in place. Only then can we be confident that the practice is sustainable and not putting additional pressure on leopard populations already under a great deal of strain from other threats."
The DEA stated that hunting would likely have a detrimental effect on the species' survival.
The research authority found that leopards had a low reproductive rate, a fragmented distribution, an uncertain population trend, and that illegal harvesting in particular was not very well controlled as the rate of monitoring was low as only between 5% and 15% of leopard habitat was strictly protected.
The trophy ban will be in effect throughout this year. The scientific authority will then review the situation and will develop norms and standards for the management and monitoring of leopard hunting throughout the country.
Source: AfricaGeographic.com
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We're just getting started in this year's online baseball betting action. MLB fans looking for a matchup to wager on this Wednesday night can check out this evening's Los Angeles Dodgers vs. St. Louis Cardinals matchup. The Cardinals were off to a decent start but have shocked sportsbooks by picking up these past two games over Los Angeles. The Dodgers on the other hand, were off to a great start but need to rebound on the road this Wednesday night. So what kind of predictions should players learning how to bet on sports make this Wednesday night?
The Dodgers enter tonight's action sporting an 8-4 record that ranks them No. 1 overall in the NL West. But with the San Diego Padres being just one game behind Los Angeles, it's clear the Dodgers need a win tonight in order to maintain the status quo. Looking over tonight's odds however, it's clear the online baseball betting odds don't think Los Angeles can get the job done. Nevertheless, the Dodgers are tasking Kenta Maeda with the starting job tonight. Maeda is 2-0 so far this season and has a 3.09 ERA and a 1.29 WHIP to his name.
All things considered, it's very surprising to see Los Angeles struggle so severely against St. Louis. After all, the Dodgers currently rank 2nd in the league in runs, second in team batting average and 1st in on base percentage. But their pitching does rank 17th in the MLB in team ERA and 10th in team WHIP. Notwithstanding that weakness, St. Louis has been beating the Dodgers by shutting them out offensively, not necessarily running up the score against them.
Players to Watch: AJ Pollock (1 HR, 9 RBI, .275 BA), Cody Bellinger (7 HR, 19 RBI, .440 BA), and Justin Turner (0 HR, 7 RBI, .295 BA).
The Cardinals fly into tonight's matchup flashing a 6-5 record that ranks them 2nd overall in the NL Central. After picking up the last two games against the Dodgers, St. Louis enter on a 3 game winning streak. Looking over the numbers, it's unquestionably clear that the strength of this team lies in their pitching. At the present time the Cardinals rank 10th in the league in team ERA, 20th in WHIP and 9th in team BAA. While that might not be that impressive, it still beats out their batting numbers. With that in mind, it's explicitly clear that the Cardinals should not be getting the better of Los Angeles. Tonight the Cardinals will be sending Jack Flaherty to the mound. Flaherty is making his first start of the season and boasts a 3.86 ERA and a 1.71 WHIP.
Players to Watch: Yadier Molina (0 HR, 4 RBI, .205 BA), Paul DeJong (3 HR, 7 RBI, .295 BA), and Matt Carpenter (1 HR, 3 RBI, .214 BA).
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Home WTTC Responds to Latest Quarantine Announcements by Greece and Portugal
WTTC Responds to Latest Quarantine Announcements by Greece and Portugal
London, United Kingdom, September 7, 2020 / TRAVELINDEX / Gloria Guevara, WTTC President & CEO, said: "WTTC shares the bewilderment of British holidaymakers and those working throughout the Travel & Tourism sector, at the absurd spectacle of completely different quarantine rules in England, Scotland and Wales for those now returning back from Greece. A similar situation is emerging with Portugal.
"This public policy lottery is creating chaos. It shows confusion, mistrust and further seriously undermines the government's credibility in the eyes of the public.
"We urgently need to restore the confidence to travel, not create more uncertainty. It is vital we have a properly coordinated response across the UK, which people – and the Travel & Tourism sector – can both understand and have confidence in.
"Blanket quarantines are disruptive, unhelpful and have a devastating economic impact. Unfortunately, there has been no plan from the government on how to abandon them and focus instead on reopening 'air corridors' between cities which have similar low coronavirus infection rates to revive international business and leisure travel responsibly.
"WTTC does welcome the government's £500 million package for COVID-19 testing. Investing in a comprehensive testing programme for travellers will be less expensive than the economic cost brought on by blanket quarantines, with its devastating impact on jobs and the millions of livelihoods that depend on this sector."
Female-led Gelato Brand Nakhati Launched in Saudi Arabia
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Riyadh, Saudi Arabia, August 24, 2022 / TRAVELINDEX / Kerten Hospitality is launching their first female-led global gelato brand...
WTTC Global Summit Hears Praise for Private Sector's United Approach
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Cancun, Quintana Roo, Mexico, April 27, 2021 / TRAVELINDEX / World Travel & Tourism Council President and CEO Gloria...
Be Messengers of Hope: Pope Francis Addresses Global Youth Tourism Summit
, July 2, 2022 July 31, 2022 , Global Travel News, 0
Rome, Italy, June 29, 2022 / TRAVELINDEX / His Holiness Pope Francis has sent an historic message of support...
WTTC Reveals Tourism Sector Contribution to South Korea GDP Dropped by $33 billion
, June 2, 2021 June 25, 2021 , Global Travel News, 0
Seoul, Korea South, June 2, 2021 / TRAVELINDEX / COVID-19 sparks a dramatic 45.5% collapse in the sector's contribution...
Michelin Restaurant Guide Thailand Will be Published 5 More Years
, December 5, 2021 January 2, 2022 , Global Travel News, 0
Bangkok, Thailand, December 3, 2021 / TRAVELINDEX / Produced both digitally and in print, the prestigious bilingual Thai and...
Return of Lotus Cars to Thailand Shifts the Premium Sports Car Market Up
Bangkok, Thailand, December 2, 2021 / TRAVELINDEX / Lotus Car Thailand, the importer and distributor of the hardcore racing...
Luxury Rosewood Hotel São Paulo Opened
, January 12, 2022 January 31, 2022 , Global Travel News, 0
São Paulo, Brazil, January 12, 2022 / TRAVELINDEX / Encapsulating the city's storied past and innovative future, the landmark...
PATA Gold Award Winners to be Announced Live September 8
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Macao, Macao SAR, September 6, 2021 / TRAVELINDEX / The Pacific Asia Travel Association (PATA) will be announcing the...
Sustainable First Joins Forces with the United Nations on its 75th AnniversaryGlobal Destinations are Easing Travel Restrictions but Caution Remains

redpajama_set_name: RedPajamaCommonCrawl


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redpajama_set_name: RedPajamaGithub


text:
Соревнования по трапу среди женщин на летних Олимпийских играх 2012 прошли 4 августа. В них приняли участие 22 спортсменки из 21 страны.

Турнир состоял из двух раундов, квалификации и финала. В первом раунде участницы выполнили 3 серий по 25 выстрелов. Шесть лучших спортсменок по итогам квалификации проходят в финал. Там каждая выполняет ещё по 25 выстрелов, после чего результаты финала и квалификации были суммированы и определили призёров.

Действующая олимпийская чемпионка из Финляндии Сату Мякеля-Нуммела по результатам перестрелки не смогла пробиться в финальный раунд.

Олимпийской чемпионкой стала итальянка Джессика Росси, которая из ста выстрелов промахнулась лишь однажды, обновив олимпийский и мировой рекорды.

Призёры

Рекорды

Результаты

Квалификация

Финал

Ссылки
 Результаты на sports-reference.com

redpajama_set_name: RedPajamaWikipedia


text:
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Lee CH, Han K, Kim DH, Kwak MS. Repeatedly elevated γ-glutamyltransferase levels are associated with an increased incidence of digestive cancers: A population-based cohort study. World J Gastroenterol 2021; 27(2): 176-188
Min-Sun Kwak, MD, PhD, Assistant Professor, Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, 39th FL. Gangnam Finance Center, 737 Yeoksam-dong, Gangnam-gu, Seoul 06236, South Korea. kms39@snuh.org
Retrospective Cohort Study
Repeatedly elevated γ-glutamyltransferase levels are associated with an increased incidence of digestive cancers: A population-based cohort study
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Jan 14, 2021 (publication date) through Jan 20, 2021
World J Gastroenterol. Jan 14, 2021; 27(2): 176-188
Published online Jan 14, 2021. doi: 10.3748/wjg.v27.i2.176
Chang-Hoon Lee, Kyungdo Han, Da Hye Kim, Min-Sun Kwak
Chang-Hoon Lee, Department of Internal Medicine, Seoul National University Hospital, Seoul 03080, South Korea
Kyungdo Han, Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, South Korea
Da Hye Kim, Department of Biostatistics, College of Medicine, Catholic University of Korea, Seoul 06591, South Korea
Min-Sun Kwak, Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul 06236, South Korea
ORCID number: Chang-Hoon Lee (0000-0001-9960-1524); Kyungdo Han (0000-0002-6096-1263); Da Hye Kim (0000-0002-2241-3960); Min-Sun Kwak (0000-0003-0353-6460).
Author contributions: Kwak MS and Lee CH contributed to the conception and design of the study, interpretation of the data, and drafting of the manuscript; Han K and Kim DH contributed to the acquisition of the data, statistical analysis, table and figure creation and critical revision of the manuscript for important intellectual content.
Institutional review board statement: This study protocol was exempted from review by the Seoul National University Hospital Institutional Review Board because of the retrospective design of the study, and the researchers accessed only de-identified open clinical data for analytical purposes (No. H-1912-022-1085).
Informed consent statement: The subjects' information in the database was de-identified before the investigator accessed the data, thus informed consent was waived.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Min-Sun Kwak, MD, PhD, Assistant Professor, Department of Internal Medicine, Healthcare Research Institute, Healthcare System Gangnam Center, Seoul National University Hospital, 39th FL. Gangnam Finance Center, 737 Yeoksam-dong, Gangnam-gu, Seoul 06236, South Korea. kms39@snuh.org
Peer-review started: October 12, 2020
First decision: November 23, 2020
Revised: December 5, 2020
Accepted: December 16, 2020
Article in press: December 16, 2020
Published online: January 14, 2021
The association between elevated γ-glutamyltransferase (GGT) at a certain point and incident cancer has been suggested; however, no study has evaluated the association between repeatedly elevated GGT and cancer incidence.
To investigate the effects of repeatedly elevated GGT on the incidence of digestive cancers.
Participants who had undergone health screening from 2009 to 2012 and 4 consecutive previous examinations were enrolled. GGT points were calculated as the number of times participants met the criteria of quartile 4 of GGT in four serial measurements (0-4 points). Multivariable Cox proportional hazard regression models were applied.
In total, 3559109 participants were included; among them, 43574 digestive cancers developed during a median of 6.8 years of follow-up. The incidence of total digestive cancers increased in a dose-response manner in men [adjusted hazard ratio (aHR) compared with those with 0 GGT points = 1.28 and 95% confidence interval (CI) = 1.24-1.33 in those with 1 point; aHR = 1.40 and 95%CI = 1.35-1.46 in those with 2 points; aHR = 1.52 and 95%CI = 1.46-1.58 in those with 3 points; aHR = 1.88 and 95%CI = 1.83-1.94 in those with 4 points; P for trend < 0.001]. This trend was more prominent in men than in women and those with healthy habits (no smoking, no alcohol consumption, and a low body mass index) than in those with unhealthy habits.
Repeatedly elevated GGT levels were associated with an increased risk of incident digestive cancer in a dose-responsive manner, particularly in men and those with healthy habits. Repeated GGT measurements may be a good biomarker of incident digestive cancer and could help physicians identify high-risk populations.
Key Words: Gamma-glutamyltransferase, Cancer, Digestive organ, Serial exam, Incident cancer, Biomarker
Core Tip: We evaluate whether repeatedly elevated γ-glutamyltransferase (GGT) levels on four consecutive exams were associated with an increased incidence of digestive cancers using the population-based cohort data. In total, 3559109 participants were included with a median of 6.8 years of follow-up. Repeatedly elevated GGT levels on four consecutive exams were associated with an increased incidence of digestive cancers in a dose-response manner. This trend was more prominent in men than women and in those with healthy habits (no smoking, no alcohol consumption, and a low body mass index) than those with unhealthy habits.
Citation: Lee CH, Han K, Kim DH, Kwak MS. Repeatedly elevated γ-glutamyltransferase levels are associated with an increased incidence of digestive cancers: A population-based cohort study. World J Gastroenterol 2021; 27(2): 176-188
URL: https://www.wjgnet.com/1007-9327/full/v27/i2/176.htm
DOI: https://dx.doi.org/10.3748/wjg.v27.i2.176
Gamma-glutamyltransferase (GGT) is the enzyme responsible for the extracellular catabolism of glutathione by catalyzing the transfer of the glutamyl residue from glutathione to an acceptor amino acid[1]. GGT is present on the external surface of most cells but is mainly present in biliary epithelial cells[2]. GGT is a well-known marker of hepatic dysfunction, cholestasis or excessive alcohol consumption[3]. However, elevated serum levels of GGT are also associated with various diseases, including non-hepatobiliary diseases, such as type 2 diabetes mellitus (DM)[4], obesity, dyslipidemia, metabolic syndrome[5], hypertension[4], chronic kidney disease[6] and cardiovascular disease[7].
Several studies have suggested that elevated serum levels of GGT are also associated with an increased incidence of digestive cancers. A population-based study showed that elevated serum GGT is associated with an increased risk of esophageal cancer[8]. Another population-based study in Korea showed that the baseline GGT had a dose-response association with incident cancers, including liver cancer and several gastrointestinal cancers[9]. A meta-analysis including 14 cohort studies showed that the overall cancer risk increased by 1.04 times per 5-U/L increment in serum GGT[10]. Nevertheless, most of these studies used a single measurement of GGT, although the GGT levels fluctuate over time. The within-subject biological variation in GGT was reported to be 13.8% (range, 3.9%-14.5%)[11]. Several other longitudinal follow-up studies also showed dynamic changes in GGT[12-14]. Furthermore, many factors affect the level of GGT, such as age, sex, ethnicity, region, alcohol consumption, smoking, underlying diseases and drugs[15,16]. Therefore, a single measurement of GGT does not fully reflect the current status of GGT, limiting the understanding of the actual relationship between GGT and diseases. We hypothesized that multiple measurements of GGT over several years could mitigate the limitations of a single measurement. In this study, we investigated whether repeatedly elevated serum GGT levels on serial measurements over 3-4 years were associated with an increased risk of incident digestive cancer using population-based data.
National Health Insurance Service data source
We used the National Health Insurance Service (NHIS) database, which is managed by the Korean government. The NHIS covers almost all Koreans (97.2% of the Korean population)[8]. The NHIS supports annual or biennial standardized national health check-ups for all insured Koreans older than 40 years and employees older than 20 years. The NHIS contains information for each participant on their demographics, examinations, disease diagnosis codes claims according to the International Classification of Diseases (ICD-10), and treatments, including medication prescribed and procedures performed[17].
This study protocol was exempted from review by the Seoul National University Hospital Institutional Review Board because of the retrospective design of the study, and the researchers accessed only de-identified open clinical data for analytical purposes (H-1912-022-1085). Informed consent from participants was also waived by the Institutional Review Board of Seoul National University Hospital because of the retrospective nature of the study, and the researchers accessed only anonymous clinical data for analytical purposes.
We initially included participants who had undergone the Korean Health screening from 2009 to 2012. Among them, we selected participants who had 4 previous serial health screening examinations, as presented in Figure 1. Next, those with missing data were excluded. Participants who were diagnosed with any cancers at baseline were excluded based on C-codes and registration programs for serious diseases before the index date. The Korean government provides co-payment reductions for registered cancer patients. Only patients with a confirmed diagnosis of cancer after a thorough evaluation by a physician can be registered in this program.
Figure 1 Definition of the γ-glutamyltransferase points and study design. The participants received one point if γ-glutamyltransferase (GGT) was in quartile 4 at each examination. The GGT points were defined as the sum of points of four examinations. GGT: Gamma-glutamyltransferase.
Participants who died or had an event within 1 year ("lag period") were also excluded. The included participants were followed until December 2017.
Measurement of clinical variables and biochemical analysis
Standardized self-administered questionnaires were collected. They included questions on age (years), sex, alcohol consumption (amount and frequency), smoking (never, former and current), regular physical activity, yearly income, and underlying diseases, including malignancy. Heavy alcohol consumption was defined as > 21 standard drinks per week based on the self-administered questionnaire[18].
Body weight (kg) and height (m2) were measured using an electronic scale, and the body mass index (BMI) was calculated as follows: BMI = body weight (kg)/height2 (m2). A BMI greater than 25 kg/m2 was used to define the obese population in the subgroup analysis. The waist circumference (WC) was measured using a tape measure at the midpoint between the iliac crest and the lower costal margin by a well-trained examiner. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured after 5 min of rest.
After overnight fasting, blood samples were collected from each participant and analyzed using a standardized laboratory method. The baseline laboratory examinations included GGT, total cholesterol, triglycerides, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, fasting glucose, aspartate aminotransferase (AST), and alanine aminotransferase (ALT).
The diagnoses of hypertension, dyslipidemia and DM were defined using anthropometric measurements or laboratory data (SBP = 140 mmHg or DBP = 90 mmHg; total cholesterol level ≥ 240 mg/dL; fasting glucose level ≥ 126 mg/dL) or ICD codes (ICD I10 to I13 or I15; E78; E11 to E14) and medication use, including antihypertensive medication, dyslipidemia medication or insulin or oral hypoglycemic agents. In the subgroup analysis, the definition of chronic liver disease or liver cirrhosis was based on ICD codes (B15-B19, K70.3, K74.6).
Definition of GGT points
Participants were assigned "GGT points" based on 4 consecutive examinations. They obtained 1 point if GGT was considered quartile 4 at each measurement. Participants who had GGT levels in quartile 4 in all four examinations received 4 GGT points; however, participants who had all GGT levels in quartiles 1-3 in the four examinations received 0 GGT points (Figure 1).
We evaluated the incidence of digestive cancers using the claim records of the NHIS during the follow-up period. The primary outcome was newly developed cancer in the gastrointestinal and hepatobiliary pancreas. Cancer was defined based on both the registration codes for serious diseases and the following ICD-10 codes: C15 (esophageal); C16 (stomach); C18-20 (colorectal); C22.0, 22.2, 22.3, 22.4, 22.7, and 22.9 (liver); C22.1, C23, and C24 (gallbladder and biliary tract); and C25 (pancreatic). Codes for reimbursement for serious diseases were also reviewed to reduce the error in studies with claims data; that is, both codes were required for the identification of cancer patients[19].
"Total digestive cancers" included both "gastrointestinal cancers" and "hepatobiliary pancreatic cancers". "Gastrointestinal cancers" included esophageal, stomach, and colorectal cancers. "Hepatobiliary pancreatic cancers" included liver, biliary (gallbladder and biliary tract), and pancreatic cancers.
Categorical variables were expressed as numbers and percentages, and continuous variables were expressed as means ± SD. For non-normally distributed variables, log transformation was performed, and geometric means were calculated. Group comparisons were performed using chi-squared tests for categorical variables and one-way analysis of variance for continuous variables.
The incidence rate of cancers was calculated as the number of events divided by the summation of person-years (per 1000). Multivariable Cox proportional hazards regression models were used to adjust covariates, and adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were presented. We also performed subgroup analyses according to the age, smoking status, alcohol consumption status, BMI, liver cirrhosis or hepatitis to evaluate whether there were effect modifications of the impact of GGT on cancer incidence in each subgroup.
Statistical analyses were performed using SAS version 9.3 (SAS Institute Inc., Cary, NC, United States) and R version 3.2.3 (The R Foundation for Statistical Computing, Vienna, Austria). A two-sided P value less than 0.05 was considered statistically significant.
The flowchart of the study enrolment is presented in Supplementary Figure 1. Among the total 3559109 included participants, 2569773 were men, and 989336 were women. More than half of both men (62.1%) and women (57.3%) had 0 GGT points. In other words, 37.9% of men and 42.7% of women had a high GGT level in at least one of the four time evaluations. In total, 10.1% of men and 15.5% of women had one point, 6.9% of men and 8.4% of women had 2 points, 7.1% of men and 7.1% of women had 3 points, and 13.8% of men and 11.7% of women had 4 points. Older age, current smoking, heavy drinking, hypertension, dyslipidemia, diabetes, high BMI, high waist circumference, elevated levels of fasting glucose, total cholesterol, triglycerides, AST, ALT and low physical activity were associated with increased GGT points in both men and women (P for trend < 0.001 for all; Table 1). The median follow-up duration was 6.8 years (5.3-7.4 years, mean 6.3 years). The univariate and multivariate analyses of the incidence of total digestive cancers, gastrointestinal cancers (esophageal, stomach and colorectal) and hepatobiliary pancreatic cancers according to the GGT points are presented in Table 2. The incidence of total digestive cancers increased as the GGT points increased. In men, the incidence of total digestive cancers increased in a dose-responsive manner as the GGT points increased compared with those who had 0 GGT points (aHR = 1.28, 95%CI = 1.24-1.33 in those with 1 GGT point; aHR = 1.40, 95%CI = 1.35-1.46 in those with 2 points; aHR = 1.52, 95%CI = 1.46-1.58 in those with 3 points; aHR = 1.88, 95%CI = 1.83-1.94 in those with 4 points; P for trend < 0.001). In women, this trend was similar, although the effect sizes were smaller than those in men (aHR = 0.99 and 95%CI = 0.93-1.06 in participants with 1 GGT point; aHR = 1.02 and 95%CI = 0.94-1.11 in those with 2 points; aHR = 1.11 and 95%CI = 1.02-1.21 in those with 3 points; aHR = 1.27 and 95%CI = 1.19-1.36 in those with 4 points; P for trend < 0.001).
Table 1 Baseline characteristics according to the γ-glutamyltransferase points.
GGT points1
Men 2569773 1595879 260084 177029 181702 355079
Age, yr 42.41 ± 10.53 41.64 ± 10.84 43.19 ± 10.47 43.31 ± 10.13 43.64 ± 9.82 44.19 ± 9.29
Non-smoker 720342 (28.03) 511103 (32.03) 65347 (25.13) 39900 (22.54) 37994 (20.91) 65998 (18.59)
Ex-smoker 662215 (25.77) 410064 (25.7) 70316 (27.04) 47571 (26.87) 47955 (26.39) 86309 (24.31)
Current 1187216 (46.2) 674712 (42.28) 124421 (47.84) 89558 (50.59) 95753 (52.7) 202772 (57.11)
No 720354 (28.03) 540201 (33.85) 64798 (24.91) 36701 (20.73) 32092 (17.66) 46562 (13.11)
Mild 1583612 (61.62) 952992 (59.72) 165116 (63.49) 114805 (64.85) 118787 (65.37) 231912 (65.31)
Heavy 265807 (10.34) 102686 (6.43) 30170 (11.6) 25523 (14.42) 30823 (16.96) 76605 (21.57)
Lowest quartile of yearly income (Q1) 399370 (15.54) 244182 (15.3) 42615 (16.39) 28596 (16.15) 28873 (15.89) 55104 (15.52)
Regular PA 790381 (30.76) 496084 (31.09) 80897 (31.1) 54551 (30.81) 55753 (30.68) 103096 (29.03)
BMI (kg/m2) 24.19 ± 3.01 23.55 ± 2.79 24.71 ± 2.91 25.1 ± 2.98 25.34 ± 3.03 25.64 ± 3.13
WC (cm) 83.14 ± 7.56 81.48 ± 7.16 84.46 ± 7.22 85.43 ± 7.25 86.08 ± 7.33 86.96 ± 7.45
SBP (mmHg) 123.78 ± 12.99 122 ± 12.45 124.88 ± 12.85 125.93 ± 13.02 126.8 ± 13.23 128.37 ± 13.68
DBP (mmHg) 77.98 ± 9.17 76.71 ± 8.79 78.75 ± 9.07 79.51 ± 9.16 80.19 ± 9.32 81.27 ± 9.6
Hypertension 543619 (21.15) 249986 (15.66) 63584 (24.45) 48861 (27.6) 55827 (30.72) 125361 (35.31)
Dyslipidemia 394282 (15.34) 169026 (10.59) 47739 (18.36) 37512 (21.19) 42552 (23.42) 97453 (27.45)
No 1747553 (68) 1178083 (73.82) 168406 (64.75) 108469 (61.27) 105608 (58.12) 186987 (52.66)
IFG 633865 (24.67) 343650 (21.53) 69127 (26.58) 50151 (28.33) 54139 (29.8) 116798 (32.89)
DM 188355 (7.33) 74146 (4.65) 22551 (8.67) 18409 (10.4) 21955 (12.08) 51294 (14.45)
Fasting glucose (mg/dL) 97.2 ± 22.15 94.38 ± 18.25 98.47 ± 22.98 100.13 ± 24.85 101.84 ± 26.59 105.13 ± 29.72
Total cholesterol (mg/dL) 195.09 ± 34.85 190.25 ± 32.83 198.57 ± 34.96 201.16 ± 35.5 202.95 ± 36.32 207.29 ± 37.85
LDL (mg/dL) 112.94 ± 32.32 112.28 ± 30.41 114.88 ± 33.13 114.76 ± 34.14 114.17 ± 35.16 112.95 ± 37.16
HDL (mg/dL) 52.16 ± 13.63 52.38 ± 13.38 51.6 ± 13.93 51.57 ± 14.01 51.58 ± 13.9 52.18 ± 14.14
Triglyceride (mg/dL)2 129.81 (129.72-129.9) 112.69 (112.6-112.78) 141.48 (141.19-141.77) 154 (153.61-154.38) 164.57 (164.16-164.98) 187.2 (186.86-187.54)
AST (IU/L)2 25.9 (25.89-25.91) 23.64 (23.63-23.65) 27.11 (27.08-27.15) 28.47 (28.43-28.51) 29.84 (29.79-29.89) 33.52 (33.47-33.56)
ALT (IU/L)2 26.41 (26.4-26.43) 22.44 (22.43-22.46) 29.54 (29.49-29.6) 32.15 (32.07-32.22) 34.42 (34.34-34.51) 40.07 (40-40.14)
GGT (U/L)2 36.3 (36.28-36.33) 24.79 (24.78-24.81) 43.21 (43.14-43.27) 53.64 (53.54-53.73) 66.15 (66.02-66.28) 107.44 (107.26-107.61)
Women 989336 566518 153299 83247 70183 116089
Age, yr 41.61 ± 11.55 39.36 ± 11.04 42.51 ± 11.54 44.13 ± 11.57 45.34 ± 11.47 47.33 ± 10.9
Non-smoker 950040 (96.03) 547422 (96.63) 147238 (96.05) 79376 (95.35) 66593 (94.88) 109411 (94.25)
Ex-smoker 16273 (1.64) 8976 (1.58) 2493 (1.63) 1454 (1.75) 1294 (1.84) 2056 (1.77)
Current 23023 (2.33) 10120 (1.79) 3568 (2.33) 2417 (2.9) 2296 (3.27) 4622 (3.98)
No 661884 (66.9) 383621 (67.72) 103332 (67.41) 55147 (66.25) 45838 (65.31) 73946 (63.7)
Mild 318233 (32.17) 179199 (31.63) 48446 (31.6) 26984 (32.41) 23345 (33.26) 40259 (34.68)
Heavy 9219 (0.93) 3698 (0.65) 1521 (0.99) 1116 (1.34) 1000 (1.42) 1884 (1.62)
Lowest quartile of yearly income (Q1) 365612 (36.96) 181102 (31.97) 61625 (40.2) 35775 (42.97) 31499 (44.88) 55611 (47.9)
Regular PA 270758 (27.37) 155736 (27.49) 42388 (27.65) 22839 (27.44) 18923 (26.96) 30872 (26.59)
BMI (kg/m2) 22.45 ± 3.22 21.79 ± 2.82 22.56 ± 3.15 23.14 ± 3.39 23.64 ± 3.53 24.36 ± 3.71
WC (cm) 73.52 ± 8.28 71.77 ± 7.42 73.86 ± 8.07 75.36 ± 8.49 76.6 ± 8.78 78.47 ± 9.09
SBP (mmHg) 116.17 ± 13.59 114.11 ± 12.72 116.63 ± 13.55 118.33 ± 14.04 119.76 ± 14.23 121.91 ± 14.56
DBP (mmHg) 72.92 ± 9.26 71.68 ± 8.83 73.17 ± 9.25 74.2 ± 9.46 75.08 ± 9.54 76.39 ± 9.73
Hypertension 130992 (13.24) 45016 (7.95) 21361 (13.93) 15255 (18.32) 15700 (22.37) 33660 (28.99)
Dyslipidemia 128796 (13.02) 45810 (8.09) 21112 (13.77) 14928 (17.93) 15084 (21.49) 31862 (27.45)
No 805990 (81.47) 489351 (86.38) 124149 (80.98) 64211 (77.13) 51316 (73.12) 76963 (66.3)
IFG 148818 (15.04) 68823 (12.15) 24264 (15.83) 15071 (18.1) 14042 (20.01) 26618 (22.93)
DM 34528 (3.49) 8344 (1.47) 4886 (3.19) 3965 (4.76) 4825 (6.87) 12508 (10.77)
Fasting glucose (mg/dL) 91.41 ± 16.31 89.21 ± 12.41 91.39 ± 15.32 93.13 ± 17.79 94.99 ± 20.38 98.8 ± 25.3
Total cholesterol (mg/dL) 190.33 ± 34.94 185.48 ± 32.85 191.82 ± 35.03 195.68 ± 35.98 198.31 ± 36.74 203.37 ± 37.76
LDL (mg/dL) 110.02 ± 31.3 106.75 ± 29.16 111.38 ± 31.72 113.91 ± 33.05 115.34 ± 33.97 118.18 ± 35.21
HDL (mg/dL) 60.82 ± 15.16 61.63 ± 14.7 60.57 ± 15.3 59.93 ± 15.73 59.3 ± 15.65 58.74 ± 16.1
Triglyceride (mg/dL)2 85.34 (85.25-85.42) 76.5 (76.4-76.59) 87.69 (87.47-87.91) 95.8 (95.47-96.13) 103.29 (102.89-103.69) 115.13 (114.78-115.49)
AST (IU/L)2 21.38 (21.36-21.39) 20.06 (20.05-20.08) 21.64 (21.61-21.67) 22.58 (22.54-22.63) 23.6 (23.55-23.66) 25.95 (25.89-26)
ALT (IU/L)2 16.82 (16.81-16.84) 14.74 (14.73-14.76) 17.38 (17.34-17.41) 19.11 (19.05-19.17) 20.85 (20.78-20.92) 24.6 (24.53-24.67)
GGT (U/L)2 17.53 (17.51-17.54) 13.52 (13.51-13.53) 18.15 (18.12-18.18) 21.94 (21.89-21.99) 26.28 (26.21-26.35) 39.57 (39.46-39.69)
1Participants receive 1 point at each examination if γ-glutamyltransferase (GGT) is in the highest quartile at each examination. GGT points were calculated as the sum of points at 4 consecutive examinations.
2Geometric mean. Categorical variables are expressed as numbers (%); continuous variables are expressed means ± SD. PA: Physical activity; BMI: Body mass index; WC: Waist circumference; SBP: Systolic blood pressure; DBP: Diastolic blood pressure; IFG: Impaired fasting glucose; DM: Diabetes mellitus; LDL: Low-density lipoprotein; HDL: High-density lipoprotein; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; GGT: Gamma-glutamyltransferase.
Table 2 Incidence of all digestive cancers, gastrointestinal cancers (including esophagus, stomach and colorectal cancers), and hepatobiliary pancreatic cancers (including liver, biliary tract and pancreas) according to the γ-glutamyltransferase points.
GGT points Number Event Duration IR per 1000 Age-adjusted
IR (95%CI)
HR (95%CI)
Total digestive cancer
0 1595879 17789 10257993.68 1.734 3.20 (3.14, 3.26) 1 (reference) 1 (reference) 1 (reference)
1 260084 4058 1667865.93 2.433 4.19 (3.88, 4.52) 1.40 (1.36, 1.45) 1.30 (1.26, 1.34) 1.28 (1.24, 1.33)
P for trend < 0.001 < 0.001 < 0.001
Hepatobiliary pancreatic cancer
0 1595879 5616 10294767.52 0.546 1.01 (0.98, 1.03) 1 (reference) 1 (reference) 1 (reference)
0 566518 3367 3558510.54 0.946 1.81 (1.77, 1.85) 1 (reference) 1 (reference) 1 (reference)
1 153299 1124 959235.81 1.172 1.75 (1.65, 1.86) 1.24 (1.16, 1.33) 1.00 (0.93, 1.07) 0.99 (0.93, 1.06)
2 83247 694 519023.27 1.337 1.80 (1.63, 1.98) 1.42 (1.30, 1.54) 1.03 (0.95, 1.12) 1.02 (0.94, 1.11)
1 153299 913 959636.19 0.951 1.43 (1.33, 1.53) 1.17 (1.09, 1.26) 0.95 (0.88, 1.03) 0.95 (0.88, 1.02)
P for trend < 0.001 0.052 0.232
0 566518 884 3565741.17 0.248 0.47 (0.45,0.49) 1 (reference) 1 (reference) 1 (reference)
Model 1: Unadjusted model. Model 2: Age-adjusted model. Model 3: Age, smoking, drinking, income, hypertension, diabetes, dyslipidemia, body mass index, and physical activity-adjusted model. IR: Incidence rate; HR: Hazard ratio; CI: confidence interval; GGT: Gamma-glutamyltransferase.
This increasing trend according to the GGT points was consistent for each digestive cancer, including esophageal, stomach, colorectal, liver, pancreatic, and biliary cancers (Table 3 and Figure 2). In particular, this trend was the most prominent for liver cancer (6.89 times the increased risk), followed by esophageal cancer (3.07 times increased risk) in the 4-GGT-point group compared with the 0-point group in men. Similarly, the risk for liver cancers was mostly increased in women (aHR = 3.91 and 95%CI = 3.25-4.71 in those with 4 GGT points vs 0 points). However, no significant association was found between each type of gastrointestinal cancer and GGT points in women.
Figure 2 Incidence of site-specific digestive cancers according to the γ-glutamyltransferase points based on four consecutive examinations in men. GGT: Gamma-glutamyltransferase.
Table 3 Incidence of site-specific digestive cancers according to the γ-glutamyltransferase points based on four consecutive examinations.
IR per 1000
0 0.037 1 (reference) 0.772 1 (reference) 0.757 1 (reference) 0.215 1 (reference) 0.126 1 (reference) 0.293 1 (reference)
1 0.073 1.78 (1.45, 2.18) 0.968 1.12 (1.06, 1.19) 0.938 1.09 (1.03, 1.15) 0.505 2.39 (2.21, 2.59) 0.203 1.46 (1.29, 1.64) 0.389 1.18 (1.08, 1.28)
Multivariate analysis was adjusted for age, smoking, drinking, income, hypertension, diabetes, dyslipidemia, body mass index and physical activity. IR: Incidence rate; HR: Hazard ratio; CI: Confidence interval.
We performed subgroup analyses (Figure 3 and Supplementary Table 1). In men, the increasing trend in GGT points was consistent in all subgroups. This trend was most evident in those with healthy lifestyles (P for interaction < 0.001 among non-smokers; P for interaction < 0.001 among non-drinkers; P for interaction < 0.001 in the non-obese group) and those with hepatitis or liver cirrhosis (P for interaction < 0.001). There was no effect modification, with only one exception in the association of GGT points and cancer incidence among women. Only the presence of hepatitis or liver cirrhosis showed a significant interaction with the association between GGT points and liver cancer and stomach cancer incidence (aHR = 11.81, 95%CI = 6.95-20.07, P for interaction < 0.001; aHR = 1.94, 95%CI = 0.96-3.93, P for interaction = 0.043).
Figure 3 Subgroup analysis of the association of γ-glutamyltransferase points and the total digestive cancer incidence. A: Smoking (no smoking vs ever smoking); B: Alcohol consumption; C: Obesity (body mass index ≥ 25); D: Chronic hepatitis or liver cirrhosis in men. GGT: Gamma-glutamyltransferase; HR: hazard ratio.
This large-scale population-based study showed that repeatedly elevated GGT levels (meeting the criteria of quartile 4) on four consecutive examinations over three years were associated with an increased incidence of digestive cancers, including esophageal, stomach, colorectal, liver, biliary and pancreatic cancers, during a median 6.8-year follow-up period. The higher was the number of GGT points, the higher was the risk of each cancer in a dose-response manner. The risk of liver cancer mostly increased as the GGT points increased. This trend was more prominent in men than in women and those with healthy habits (no smoking, no alcohol consumption, and a low BMI) than in those with unhealthy habits.
Several previous studies have shown an association between the GGT levels and incident digestive cancer. The Swedish Amoris cohort study showed the association between baseline GGT levels and the incidence of cancer, including liver cancer[20]. The Ohsaki cohort study in Japan showed the association of GGT levels and colorectal cancer incidence[21]. A meta-analysis including 1.7 million participants reported pooled relative risks of 1.32 (1.15-1.52) for overall cancers and 1.94 (1.35-2.79) for digestive cancers in the highest quartile vs the bottom third of baseline GGT levels[10]. However, these studies used a single measurement of GGT to investigate the relationship between GGT and the risk of digestive cancers. A single measurement of GGT has limitations, as described above in the introduction. Our study showed that repeated measurements have the benefit of mitigating the limitations of a single measurement of GGT in the screening of those at risk of cancer. In the current study, 37.9% of men and 42.7% of women had a high GGT level in at least one of four measurements. Among them, 27% of men (10.1% of men in total) and 36% of women (15.5% of women in total) had a high GGT level only once. Thus, most of them would have been classified into a low-level GGT group if they had undergone a single measurement during that period. Additionally, participants who had 2 or more GGT points had a higher risk of incident digestive cancer than those with 1 GGT point who had a high GGT level only once. A dose-response relationship was found between the GGT points and risk of incident digestive cancer. Those with 1 GGT point did not show a higher risk of cancer than those with 0 GGT points, but those with higher GGT points showed a higher risk of cancer than those with 0 GGT points for several cancers. (e.g., biliary and pancreatic cancers in women, as shown in Table 3). In one study, the GGT levels were measured several times; however, the main outcome was the association between only the baseline GGT and site-specific cancers, and the changing status of GGT was not fully evaluated. Moreover, alcohol consumption, which is the most important confounder, was not adjusted[22,23] In the current study, we adjusted for various major confounders, including alcohol consumption and physical activity, in a nationwide, population-based, large-scale study.
The underlying biological mechanisms of the effect of repeatedly elevated levels of GGT and cancer incidence cannot be fully explained considering the epidemiologic study design of this study. GGT is a marker of oxidative stress[24]. The involvement of the pro-oxidant activity of GGT can serve as an additional source of endogenous reactive oxygen species in cancer cells. This activity can contribute to persistent oxidative stress, modulate important redox-sensitive processes, affect the proliferation and apoptosis of cells, and cause genomic instability and carcinogenesis[25,26]. This mechanism might explain the possible role of GGT in cancer incidence.
The association between GGT and total digestive cancer incidence was more prominent in men than in women, and the association between GGT and gastrointestinal cancers was present in only men. The cause might be the higher level of GGT in men than in women, as presented in other studies[9,20,21,27]. The GGT levels were lower in women than in men (mean 17.5 vs 36.3) in this study; thus, the relative effect sizes were smaller in women than in men. Another plausible explanation is that a sex effect modification may exist regarding the association between GGT and cancer incidence. The sex-related variability of the effect of GGT on cancer incidence may be due to sex-specific genetic variations or mutations or sex-specific responses to exposed carcinogens or environmental factors[27,28].
Another interesting finding is that GGT points had a greater association with incident digestive cancer in the subgroup with a healthy lifestyle (no smoking, no alcohol consumption, no obesity) than in the subgroup with an unhealthy lifestyle, although the difference in each site-specific cancer should be considered. The risk of cancer was the highest in liver cancer, followed by esophageal cancer according to the GGT points in men. Because these two cancers are well-known alcohol-associated cancers, some may hypothesize that the association between GGT points and cancer may be attributable to residual confounding by alcohol intake. A previous study in Japan showed a positive association between GGT and alcohol-related cancers among only current drinkers[21]. However, another study conversely showed an association between baseline GGT and cancer incidence regardless of the drinking and smoking status[9]. Our study found similar results to the latter and even showed a highly prominent association between GGT and cancer in the never smoker and no drinking groups. The exact underlying mechanism of this phenomenon is unknown. However, one possible explanation is that the effect of GGT points on cancer incidence might have been weakened by other well-known cancer risk factors in participants with unhealthy habits. This result suggests that elevated GGT, which can be detected using an inexpensive and simple test is a risk factor in those without other commonly known cancer risk factors, such as smoking, alcohol or obesity. Additional attention should be given to patients with repeatedly elevated GGT levels on serial examinations, particularly those who are not smokers, heavy alcohol consumers or obese.
Our nationwide population-based study showed an association between repeatedly elevated GGT and the incidence of digestive cancers in a dose-response manner, even after adjustment for major confounders, including alcohol consumption. A single measurement of serum GGT is an easy and inexpensive test but has limitations; thus, repeated measurements could provide more useful information in the health screening setting. The repeated measurement of GGT may be a good biomarker for predicting cancer incidence and could help physicians identify those at high-risk for digestive cancers, even in those with healthy habits.
The association between elevated γ-glutamyltransferase (GGT) at a certain point and incident cancer has been suggested; however, no study has studied the association between repeatedly elevated GGT and cancer incidence.
GGT levels are not fixed but dynamic, and many factors affect the level of GGT. Therefore, a single measurement of GGT does not fully reflect the current status of GGT, limiting the understanding of the actual relationship between GGT and diseases. We hypothesized that multiple measurements of GGT over several years could mitigate the limitations of a single measurement.
To elucidate whether repeatedly elevated GGT levels, which are commonly practiced in routine health examinations, can be used as a biomarker of subsequent incidence of digestive cancer.
A population-based longitudinal cohort study was conducted with the participants who had undergone health screening from 2009 to 2012 and 4 consecutive previous examinations. GGT points were calculated as the number of times participants met the criteria of quartile 4 of GGT in four serial measurements (0-4 points). Multivariable Cox proportional hazard regression models were applied.
Among 3559109 participants, 43574 digestive cancers developed during a median of 6.8 years of follow-up. The incidence of total digestive cancers increased according to GGT points in a dose-response manner in men [adjusted hazard ratio (aHR) compared with those with 0 GGT points = 1.28 and 95% confidence interval (CI) = 1.24-1.33 in those with 1 point; aHR = 1.40 and 95%CI = 1.35-1.46 in those with 2 points; aHR = 1.52 and 95%CI = 1.46-1.58 in those with 3 points; aHR = 1.88 and 95%CI = 1.83-1.94 in those with 4 points; P for trend < 0.001]. This trend was more prominent in men than in women and those with healthy habits (no smoking, no alcohol consumption, and a low body mass index) than in those with unhealthy habits.
Repeatedly elevated GGT levels were associated with an increased risk of incident digestive cancer in a dose-responsive manner, particularly in men and those with healthy habits.
Repeated GGT measurements may be a good biomarker of incident digestive cancer and could help physicians identify high-risk populations.
Specialty type: Gastroenterology and hepatology
Country/Territory of origin: South Korea
Peer-review report's scientific quality classification
Grade C (Good): C, C
Grade D (Fair): 0
P-Reviewer: Sharma K S-Editor: Gao CC L-Editor: A P-Editor: Liu JH
1. Whitfield JB. Gamma glutamyl transferase. Crit Rev Clin Lab Sci. 2001;38:263-355. [PubMed] [DOI]
2. Smith GS, Walter GL, Walker RM. Haschek and Rousseaux's Handbook of Toxicologic Pathology. 3rd ed. Academic Press; 2013: 565-594. [PubMed] [DOI]
3. Teschke R, Rauen J, Neuefeind M, Petrides AS, Strohmeyer G. Alcoholic liver disease associated with increased gamma-glutamyltransferase activities in serum and liver. Adv Exp Med Biol. 1980;132:647-654. [PubMed] [DOI]
4. Lee DH, Jacobs DR Jr, Gross M, Kiefe CI, Roseman J, Lewis CE, Steffes M. Gamma-glutamyltransferase is a predictor of incident diabetes and hypertension: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Clin Chem. 2003;49:1358-1366. [PubMed] [DOI]
5. Lee MY, Hyon DS, Huh JH, Kim HK, Han SK, Kim JY, Koh SB. Association between Serum Gamma-Glutamyltransferase and Prevalence of Metabolic Syndrome Using Data from the Korean Genome and Epidemiology Study. Endocrinol Metab (Seoul). 2019;34:390-397. [PubMed] [DOI]
6. Ryu S, Chang Y, Kim DI, Kim WS, Suh BS. gamma-Glutamyltransferase as a predictor of chronic kidney disease in nonhypertensive and nondiabetic Korean men. Clin Chem. 2007;53:71-77. [PubMed] [DOI]
7. Wannamethee G, Ebrahim S, Shaper AG. Gamma-glutamyltransferase: determinants and association with mortality from ischemic heart disease and all causes. Am J Epidemiol. 1995;142:699-708. [PubMed] [DOI]
8. Choi YJ, Lee DH, Han KD, Yoon H, Shin CM, Park YS, Kim N. Elevated serum gamma-glutamyltransferase is associated with an increased risk of oesophageal carcinoma in a cohort of 8,388,256 Korean subjects. PLoS One. 2017;12:e0177053. [PubMed] [DOI]
9. Mok Y, Son DK, Yun YD, Jee SH, Samet JM. γ-Glutamyltransferase and cancer risk: The Korean cancer prevention study. Int J Cancer. 2016;138:311-319. [PubMed] [DOI]
10. Kunutsor SK, Apekey TA, Van Hemelrijck M, Calori G, Perseghin G. Gamma glutamyltransferase, alanine aminotransferase and risk of cancer: systematic review and meta-analysis. Int J Cancer. 2015;136:1162-1170. [PubMed] [DOI]
11. Carobene A, Braga F, Roraas T, Sandberg S, Bartlett WA. A systematic review of data on biological variation for alanine aminotransferase, aspartate aminotransferase and γ-glutamyl transferase. Clin Chem Lab Med. 2013;51:1997-2007. [PubMed] [DOI]
12. André P, Balkau B, Born C, Charles MA, Eschwège E; D. E.S.I.R. study group. Three-year increase of gamma-glutamyltransferase level and development of type 2 diabetes in middle-aged men and women: the D.E.S.I.R. cohort. Diabetologia. 2006;49:2599-2603. [PubMed] [DOI]
13. Hong SH, Han K, Park S, Kim SM, Kim NH, Choi KM, Baik SH, Park YG, Yoo HJ. Gamma-Glutamyl Transferase Variability and Risk of Dementia in Diabetes Mellitus: A Nationwide Population-Based Study. J Clin Endocrinol Metab. 2020;105. [PubMed] [DOI]
14. Strasak AM, Kelleher CC, Klenk J, Brant LJ, Ruttmann E, Rapp K, Concin H, Diem G, Pfeiffer KP, Ulmer H; Vorarlberg Health Monitoring and Promotion Program Study Group. Longitudinal change in serum gamma-glutamyltransferase and cardiovascular disease mortality: a prospective population-based study in 76,113 Austrian adults. Arterioscler Thromb Vasc Biol. 2008;28:1857-1865. [PubMed] [DOI]
15. Tynjälä J, Kangastupa P, Laatikainen T, Aalto M, Niemelä O. Effect of age and gender on the relationship between alcohol consumption and serum GGT: time to recalibrate goals for normal ranges. Alcohol Alcohol. 2012;47:558-562. [PubMed] [DOI]
16. Koenig G, Seneff S. Gamma-Glutamyltransferase: A Predictive Biomarker of Cellular Antioxidant Inadequacy and Disease Risk. Dis Markers. 2015;2015:818570. [PubMed] [DOI]
17. Song SO, Jung CH, Song YD, Park CY, Kwon HS, Cha BS, Park JY, Lee KU, Ko KS, Lee BW. Background and data configuration process of a nationwide population-based study using the korean national health insurance system. Diabetes Metab J. 2014;38:395-403. [PubMed] [DOI]
18. Chalasani N, Younossi Z, Lavine JE, Charlton M, Cusi K, Rinella M, Harrison SA, Brunt EM, Sanyal AJ. The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. Hepatology. 2018;67:328-357. [PubMed] [DOI]
19. Choi YJ, Lee DH, Han KD, Yoon H, Shin CM, Park YS, Kim N. Adult height in relation to risk of cancer in a cohort of 22,809,722 Korean adults. Br J Cancer. 2019;120:668-674. [PubMed] [DOI]
20. Van Hemelrijck M, Jassem W, Walldius G, Fentiman IS, Hammar N, Lambe M, Garmo H, Jungner I, Holmberg L. Gamma-glutamyltransferase and risk of cancer in a cohort of 545,460 persons - the Swedish AMORIS study. Eur J Cancer. 2011;47:2033-2041. [PubMed] [DOI]
21. Tsuboya T, Kuriyama S, Nagai M, Hozawa A, Sugawara Y, Tomata Y, Kakizaki M, Nishino Y, Tsuji I. Gamma-glutamyltransferase and cancer incidence: the Ohsaki cohort study. J Epidemiol. 2012;22:144-150. [PubMed] [DOI]
22. Strasak AM, Rapp K, Brant LJ, Hilbe W, Gregory M, Oberaigner W, Ruttmann E, Concin H, Diem G, Pfeiffer KP, Ulmer H; VHM&PP Study Group. Association of gamma-glutamyltransferase and risk of cancer incidence in men: a prospective study. Cancer Res. 2008;68:3970-3977. [PubMed] [DOI]
23. Strasak AM, Pfeiffer RM, Klenk J, Hilbe W, Oberaigner W, Gregory M, Concin H, Diem G, Pfeiffer KP, Ruttmann E, Ulmer H; Vorarlberg Health Monitoring and Promotion Program Study Group. Prospective study of the association of gamma-glutamyltransferase with cancer incidence in women. Int J Cancer. 2008;123:1902-1906. [PubMed] [DOI]
24. Lee DH, Blomhoff R, Jacobs DR Jr. Is serum gamma glutamyltransferase a marker of oxidative stress? Free Radic Res. 2004;38:535-539. [PubMed] [DOI]
25. Toyokuni S, Okamoto K, Yodoi J, Hiai H. Persistent oxidative stress in cancer. FEBS Lett. 1995;358:1-3. [PubMed] [DOI]
26. Corti A, Franzini M, Paolicchi A, Pompella A. Gamma-glutamyltransferase of cancer cells at the crossroads of tumor progression, drug resistance and drug targeting. Anticancer Res. 2010;30:1169-1181. [PubMed] [DOI]
27. Zheng D, Trynda J, Williams C, Vold JA, Nguyen JH, Harnois DM, Bagaria SP, McLaughlin SA, Li Z. Sexual dimorphism in the incidence of human cancers. BMC Cancer. 2019;19:684. [PubMed] [DOI]
28. Czene K, Lichtenstein P, Hemminki K. Environmental and heritable causes of cancer among 9.6 million individuals in the Swedish Family-Cancer Database. Int J Cancer. 2002;99:260-266. [PubMed] [DOI]


In fact, it wasn't until about nine days later that the 55-year-old woman noticed anything unusual at all, when a swollen lump developed on her forehead, according to a recent report of her case.
These hunches proved correct: The small opening in the skin was actually a breathing hole for a baby fly, or maggot, said lead case report author Dr. Farah Shahi, an infectious-disease specialist at York Teaching Hospital in the U.K., who was involved in the woman's treatment.
To remove the maggot, doctors started by applying petroleum jelly to the opening, which is also called a "punctum." This blocks the insect's source of air, coaxing it to move closer to the surface of the skin so it's easier to remove.
Then, they were able to successfully remove the live maggot from the woman's forehead. The fly was identified as a Lund's fly (Cordylobia rodhaini), a species native to the African rainforests that rarely infests people, according to the case report.
So, how did the fly wind up there? The woman likely came in contact with the insect when she wrapped her hair in a damp towel that had maggots on it, Shahi told Live Science. The towel had been hanging on an outdoor clothing line, and a fly could've laid its eggs on the towel, which hatched into maggots.
The forehead is considered an unusual site for a maggot to infest human skin, and there has been only one previous case in the U.K. of such an infestation, according to the report. Rather, skin infestations from the Lund's fly are more commonly found on the chest, back, stomach and thighs.


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Classic Car race Espíritu de Montjuïc
On the weekend March 6.-7., the Espíritu de Montjuïc event on the Barcelona-Catalunya circuit launched the 2019 season of series by Peter Auto. This year, no fewer than six meetings and eight grids are on the calendar.
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In 2004, Peter Auto introduced Classic Endurance Racing as a support grid for the Le Mans Series meetings. Fifteen years later CER has been transformed into one of the leading grids at Peter Auto events and it has been an inspiration for several more! Since its creation, six other grids have followed the trail it has blazed each one celebrating an era and a theme associated with endurance racing: exceptional cars in The Greatest's Trophy, GTs from the 1960s in Sixties' Endurance, Porsche 911s in the 2.0L Cup, the Francorchamps 24 Hours from the halcyon era of touring car racing in the Heritage Touring Cup, prototypes from the 1980s in Group C Racing and now supercars from the 1990s-2000s in Endurance Racing Legends.
The latter, introduced last year as demonstrations, was being held as a race for the first time this weekend. Thus, certain observers who arrived at Montmeló were still asking themselves whether it was a good idea to organise a confrontation between relatively recent cars equipped with technologies that are difficult to operate in the context of motor races. Their questions were answered out on the track thanks to a fantastic battle between an Aston Martin DBR9, Bentley Speed 8, Chrysler Viper, Ferrari 333 SP, Panoz Esperante GT1…
Other notable cars present at the Catalonian event that have not been seen racing for a long time were a Ferrari 250 GTO (1962), a 3.8-litre low-drag lightweight E-Type Jaguar (1963), an Alfa Romeo T33/TT3 (1972), a Lotus Esprit (1979), a Lola T600 (1981) and a Sauber C8 Kouros (1986). And there will be more next month at Spa-Classic starting with a Jaguar XJS/R entered for the Heritage Touring Cup. More proof, as if it were needed, that historic racing isn't static and that the events are in a state of perpetual renewal.
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