title: Circulating Markers of Liver Function and Cardiovascular Disease Risk.
abstract: Measurement of serum concentrations of various liver enzymes and other nonenzymatic proteins and metabolites of heme metabolism (eg, bilirubin) is often undertaken in clinical practice. Measurement of these liver function tests is simple, quick, and relatively inexpensive. However, interpreting the liver function test results in patients without evidence of liver disease is often challenging. Concentrations of some of liver enzymes, such as γ-glutamyltransferase or alkaline phosphatase, and concentrations of liver-derived metabolites, such as bilirubin, may be influenced by metabolic processes beyond the liver, sometimes making interpretation of the test results difficult. This scenario frequently occurs both in individuals at risk of cardiovascular disease and in patients with known cardiovascular disease, often resulting in the clinicians ignoring the test results. In this brief review, we discuss the evidence for associations between key serum liver function tests and cardiovascular disease risk and where associations are robust; we provide an interpretation for possible mechanistic links between the liver function test and cardiovascular disease.
authors.affiliation: From the Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy (G.T.); Nutrition and Metabolism, Faculty of Medicine, University of Southampton, Southampton, United Kingdom (C.D.B.); and Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton, United Kingdom (C.D.B.). giovanni.targher@univr.it.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Targher
authors.affiliation: From the Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy (G.T.); Nutrition and Metabolism, Faculty of Medicine, University of Southampton, Southampton, United Kingdom (C.D.B.); and Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton, United Kingdom (C.D.B.).
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Byrne
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D004796:Clinical Enzyme Tests; D006801:Humans; D008099:Liver / Q000201:enzymology*; D008107:Liver Diseases / Q000097:blood / Q000150:complications* / Q000175:diagnosis; D008111:Liver Function Tests; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D015415:Biomarkers
keywords: bilirubin; cardiovascular diseases; gamma-glutamyltransferase; transaminases