Ruben Hernaez1,2, Hsin-Chieh Yeh3,4,5, Mariana Lazo6,7,8, Hui-Ming Chung9,10, James P Hamilton11, Ayman Koteish12, James J Potter13, Frederick L Brancati14,15,16, Jeanne M Clark17,18,19. 1. Department of Medicine, The Johns Hopkins School of Medicine, 2024 East Monument Street, Suite 2-600, Baltimore, MD, 21287, USA. rhernaez@jhsph.edu. 2. Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. rhernaez@jhsph.edu. 3. Department of Medicine, The Johns Hopkins School of Medicine, 2024 East Monument Street, Suite 2-600, Baltimore, MD, 21287, USA. hcyeh@jhsph.edu. 4. Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. hcyeh@jhsph.edu. 5. Welch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins University, Baltimore, MD, USA. hcyeh@jhsph.edu. 6. Department of Medicine, The Johns Hopkins School of Medicine, 2024 East Monument Street, Suite 2-600, Baltimore, MD, 21287, USA. mlazo@jhsph.edu. 7. Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. mlazo@jhsph.edu. 8. Welch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins University, Baltimore, MD, USA. mlazo@jhsph.edu. 9. Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. hchung@jhsph.edu. 10. Department of Medical Research, Mennonite Christian Hospital, Hualian City, Taiwan. hchung@jhsph.edu. 11. Department of Medicine, The Johns Hopkins School of Medicine, 2024 East Monument Street, Suite 2-600, Baltimore, MD, 21287, USA. jpahamilton@jhmi.edu. 12. Department of Medicine, The Johns Hopkins School of Medicine, 2024 East Monument Street, Suite 2-600, Baltimore, MD, 21287, USA. akoteish@jhmi.edu. 13. Department of Medicine, The Johns Hopkins School of Medicine, 2024 East Monument Street, Suite 2-600, Baltimore, MD, 21287, USA. jpotter@jhmi.edu. 14. Department of Medicine, The Johns Hopkins School of Medicine, 2024 East Monument Street, Suite 2-600, Baltimore, MD, 21287, USA. fbrancat@jhmi.edu. 15. Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. fbrancat@jhmi.edu. 16. Welch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins University, Baltimore, MD, USA. fbrancat@jhmi.edu. 17. Department of Medicine, The Johns Hopkins School of Medicine, 2024 East Monument Street, Suite 2-600, Baltimore, MD, 21287, USA. jmclark@jhmi.edu. 18. Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. jmclark@jhmi.edu. 19. Welch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins University, Baltimore, MD, USA. jmclark@jhmi.edu.
Abstract
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.
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.
Authors: Nisa M Maruthur; Shari Bolen; Kimberly Gudzune; Frederick L Brancati; Jeanne M Clark Journal: Cancer Epidemiol Biomarkers Prev Date: 2012-04-04 Impact factor: 4.254
Authors: Douglas S Lee; Jane C Evans; Sander J Robins; Peter W Wilson; Irene Albano; Caroline S Fox; Thomas J Wang; Emelia J Benjamin; Ralph B D'Agostino; Ramachandran S Vasan Journal: Arterioscler Thromb Vasc Biol Date: 2006-11-09 Impact factor: 8.311