TY - JOUR
T1 - Elevated ALT and GGT predict all-cause mortality and hepatocellular carcinoma in Taiwanese male
T2 - A case-cohort study
AU - Hernaez, Ruben
AU - Yeh, Hsin Chieh
AU - Lazo, Mariana
AU - Chung, Hui Ming
AU - Hamilton, James P.
AU - Koteish, Ayman
AU - Potter, James J.
AU - Brancati, Frederick Louis
AU - Clark, Jeanne M.
N1 - Funding Information:
Acknowledgements RH and ML were supported by the American Diabetes Association Mentor-Based Postdoctoral Fellowship program awarded to Dr. F. L. Brancati (7-07-MN-08). H–CY has received support from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Diabetes Research and Training Center (P60-DK-079637). FLB has received support from the NIDDK Diabetes Research and Training Center (P60-DK-079637) and from the NIDDK (K24-DK-62222). The authors are grateful to the MJ Health Study participants and MJ Co. for providing the data.
PY - 2013/10
Y1 - 2013/10
N2 - Purpose: Evidence indicates a positive association between liver enzymes and the risk of death in Western countries; however, the evidence in Asian populations is scarce. We investigated the association between liver enzymes and total, cardiovascular (CVD), cancer and hepatocellular carcinoma (HCC) mortality in a cohort of Taiwanese male free of cancer at baseline. Methods: From 1996 to 2003, 54,751 Taiwanese male aged 40-80 years without cancer completed a health screening and were followed through 2005 (5.8 ± 2.5 years of follow-up). A random cohort of 3,961 male was selected to compare to 1,864 male who died. We used Cox proportional hazards regression models to assess the risk of all-cause, cardiovascular and cancer mortality associated with alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma glutamyl transferase (GGT). Results: In this population, higher levels of ALT, AST and GGT were significantly associated with all-cause mortality [hazard ratio (HR) 1.2, 1.8 and 1.6 for ALT, AST and GGT, respectively; all p < 0.05], cancer mortality (HR 1.8-2.8) and HCC mortality (HR 5.5-36.1). GGT was significantly associated with CVD mortality (HR 1.2). Conclusions: In Taiwanese male free of cancer at baseline, elevations of ALT, AST and GGT were associated with future risk of all-cause death, all cancer and HCC mortality, independent of conventional risk factors, and could be used to identify male who would benefit from HCC screening.
AB - Purpose: Evidence indicates a positive association between liver enzymes and the risk of death in Western countries; however, the evidence in Asian populations is scarce. We investigated the association between liver enzymes and total, cardiovascular (CVD), cancer and hepatocellular carcinoma (HCC) mortality in a cohort of Taiwanese male free of cancer at baseline. Methods: From 1996 to 2003, 54,751 Taiwanese male aged 40-80 years without cancer completed a health screening and were followed through 2005 (5.8 ± 2.5 years of follow-up). A random cohort of 3,961 male was selected to compare to 1,864 male who died. We used Cox proportional hazards regression models to assess the risk of all-cause, cardiovascular and cancer mortality associated with alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma glutamyl transferase (GGT). Results: In this population, higher levels of ALT, AST and GGT were significantly associated with all-cause mortality [hazard ratio (HR) 1.2, 1.8 and 1.6 for ALT, AST and GGT, respectively; all p < 0.05], cancer mortality (HR 1.8-2.8) and HCC mortality (HR 5.5-36.1). GGT was significantly associated with CVD mortality (HR 1.2). Conclusions: In Taiwanese male free of cancer at baseline, elevations of ALT, AST and GGT were associated with future risk of all-cause death, all cancer and HCC mortality, independent of conventional risk factors, and could be used to identify male who would benefit from HCC screening.
KW - Asia
KW - Checkup
KW - Hazard ratio
KW - Longitudinal study
KW - Nonalcoholic fatty liver disease
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U2 - 10.1007/s12072-013-9476-6
DO - 10.1007/s12072-013-9476-6
M3 - Article
C2 - 26202033
AN - SCOPUS:84890501293
SN - 1936-0533
VL - 7
SP - 1040
EP - 1049
JO - Hepatology International
JF - Hepatology International
IS - 4
ER -