GGT

This study investigated the longitudinal association of liver enzymes, particularly γ-glutamyl transferase (GGT), with insulin resistance and the risk of gestational diabetes mellitus (GDM) in a prospective cohort of 117 GDM cases and 232 matched controls. GGT levels, measured at two time points (10–13 weeks and 16–19 weeks gestation), were positively associated with elevated fasting glucose, increased HOMA-IR, and decreased adiponectin levels, even after adjusting for confounders. Women in the highest quartile of GGT levels had a 3.01- to 3.51-fold increased risk of GDM compared to those in the lowest quartile. A progressive increase in GGT levels from early to mid-pregnancy or stably high GGT levels further elevated GDM risk. Although alanine aminotransferase (ALT) showed similar but non-significant trends, the study concludes that elevated and progressively increasing GGT levels during pregnancy, even within normal ranges, may contribute to GDM pathogenesis, highlighting their potential role in early screening and prevention strategies.