title: A constellation of cardiovascular risk factors is associated with hepatic enzyme elevation in hyperlipidemic patients.
abstract: Abnormal circulating levels of hepatic enzymes are frequently found in subjects displaying hyperlipidemia or obesity or both. At present, there is a paucity of information on the principal cardiovascular risk factors that are associated with elevated plasma levels of hepatic enzyme activity in hyperlipidemic patients. We analyzed the potential relationships between serum levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma glutamyl transferase (GGT) and cardiovascular and metabolic risk factors in a cohort of 8,501 men and women referred to our outpatient clinic for hyperlipidemia by their general practitioner. In this cohort, 27.6% of patients displayed serum levels of ALT above the upper limit of normal values. Both men and women who exhibited ALT levels superior to the upper limit of the normal range had elevated systolic (SBP) and diastolic blood pressure (DBP), body mass index (BMI), alcohol intake, and serum levels of blood glucose, uric acid, total cholesterol, and triglycerides (P <.0035 for all parameters). In a multivariate analysis, BMI, uric acid, and blood glucose remained significantly associated with ALT levels in men and women. We conclude that cardiovascular and metabolic features characterizing the plurimetabolic syndrome, including serum uric acid levels, are associated with significant elevation of hepatic enzyme activities. Because these abnormalities may not only be reversible but also associated with a poor prognosis, further studies are needed to identify those dyslipidemic patients who are at risk for the development of severe hepatic tissue damage.
authors.affiliation: Department of Endocrinology, INSERM U 551 and IFR Caeur Muscle Vaisseau, Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Bruckert
authors.forename: P
authors.initials: P
authors.lastname: Giral
authors.forename: V
authors.initials: V
authors.lastname: Ratziu
authors.forename: T
authors.initials: T
authors.lastname: Poynard
authors.forename: M J
authors.initials: MJ
authors.lastname: Chapman
authors.forename: P
authors.initials: P
authors.lastname: Opolon
authors.forename: G
authors.initials: G
authors.lastname: Turpin
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology*; D008076:Cholesterol, HDL / Q000097:blood; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000201:enzymology*; D008099:Liver / Q000201:enzymology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014527:Uric Acid / Q000097:blood; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D014527:Uric Acid; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase