Persistently elevated serum gamma-glutamyl transferase is associated with pancreatic cyst development: A sex-stratified propensity score matched multicenter cohort study

Backgrounds/Aims: Elevated gamma-glutamyl transferase (GGT) levels have been linked to various malignancies, yet their relationship with pancreatic cyst development remains largely unexplored. This study aimed to investigate the association between persistently elevated serum GGT levels and pancreatic cyst formation. Methods: This retrospective cohort study utilized data from TriNetX. Adult patients were categorized by sex into high and low GGT cohorts based on quartile values (males: ≥ 57 U/L vs. ≤ 23 U/L; females: ≥ 26 U/L vs. ≤ 14 U/L). Patients were required to have sustained GGT measurements at three different time points. The primary outcomes included pancreatic cyst development, all-cause mortality, and hospitalization over a three-year follow-up period. All-cause mortality was higher in the high GGT groups (males: HR 2.670, 95% CI 2.452-2.908; females: HR 3.372, 95% CI 2.892-3.931). Hospitalization rates were also elevated (males: HR 1.546; females: HR 1.551). Conclusions: Persistently elevated serum GGT levels were associated with an approximately two-fold increase in the hazard of pancreatic cyst diagnosis in both sexes. However, the absolute event rate was low, and the outcome was identified through diagnostic coding without imaging or pathological confirmation.