title: Normal serum aminotransferase concentration and risk of mortality from liver diseases: prospective cohort study.
abstract: OBJECTIVE
  To examine the relation between the normal range of serum aminotransferase concentration and mortality from liver disease.
  
  
  METHODS
  Prospective cohort study.
  
  
  METHODS
  Korea Medical Insurance Corporation study with eight years' follow up.
  
  
  METHODS
  94,533 men and 47,522 women aged 35-59 years.
  
  
  METHODS
  Mortality from liver diseases according to death certificate.
  
  
  RESULTS
  There was a positive association between the aminotransferase concentration, even within normal range (35-40 IU/l), and mortality from liver disease. Compared with the concentration < 20 IU/l, the adjusted relative risks for an aspartate aminotransferase concentration of 20-29 IU/l and 30-39 IU/l were 2.5 (95% confidence interval 2.0 to 3.0) and 8.0 (6.6 to 9.8) in men and 3.3 (1.7 to 6.4) and 18.2 (8.1 to 40.4) in women, respectively, The corresponding risks for alanine aminotransferase were 2.9 (2.4 to 3.5) and 9.5 (7.9 to 11.5) in men and 3.8 (1.9 to 7.7) and 6.6 (1.5 to 25.6) in women, respectively. According to receiver operating characteristic curves the best cut-off values for the prediction of liver disease in men were 31 IU/l for aspartate aminotransferase and 30 IU/l for alanine aminotransferase.
  
  
  CONCLUSIONS
  People with slightly increased aminotransferase activity, but still within the normal range, should be closely observed and further investigated for liver diseases.
authors.affiliation: Department of Preventive Medicine and Public Health, Yonsei University College of Medicine, 134 Shinchon-Dong, Seodaemun-Gu, Seoul 120-752, Republic of Korea.
authors.forename: Hyeon Chang
authors.initials: HC
authors.lastname: Kim
authors.forename: Chung Mo
authors.initials: CM
authors.lastname: Nam
authors.forename: Sun Ha
authors.initials: SH
authors.lastname: Jee
authors.forename: Kwang Hyub
authors.initials: KH
authors.lastname: Han
authors.forename: Dae Kyu
authors.initials: DK
authors.lastname: Oh
authors.forename: Il
authors.initials: I
authors.lastname: Suh
mesh_terms: D000328:Adult; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008107:Liver Diseases / Q000201:enzymology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D017678:Sex Distribution; D000637:Transaminases / Q000097:blood*
chemical_list: D000637:Transaminases