Background/Aims Gamma-glutamyl transferase (GGT) is a known surrogate marker of hepatic dysfunction and oxidative stress. However, data on its association with pancreatic disease, especially pancreatic cystic neoplasm, is unknown. This study aimed to investigate the association of GGT with the incidence of pancreatic cystic neoplasm. Methods Participants who received general health checkup by National Health Insurance Service in 2009 were included. Newly diagnosed cases of pancreatic cystic neoplasms from one year after the health checkup to 2020, the end of the study period, were identified. Participants were divided into quartile groups based on GGT levels. Multivariable cox proportional hazard models were used to estimate the risk of pancreatic cystic neoplasms according to GGT quartile (Q1-Q4). Results There were 28,940 cases of pancreatic cystic neoplasms among 2,655,665 eligible participants. The incidence rate was 1.09 cases per 1,000 person-years, with a median follow-up of 10.32 (IQR: 10.09-10.58) years. In multivariate regression analysis, adjusted hazard ratios for GGT quartiles using Q1 group as a reference were: 1.043 (95% CI: 1.009-1.079) for Q2, 1.075 (95% CI: 1.039-1.111) for Q3, and 1.138 (95% CI: 1.099-1.178) for Q4. Conclusions Higher GGT level was associated with increased risk of pancreatic cystic neoplasms. Therefore, serum GGT levels might have a role as a biomarker for the development of PCN.

The authors have declared no competing interest.

This study did not receive any funding

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This study was approved by the Institutional Review Board (IRB) of Seoul National University Hospital (IRB No. H-2406-052-1542)

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All data produced in the present study are available upon reasonable request to the authors