title: Alanine aminotransferase and gamma-glutamyl transferase have different dose-response relationships with risk of mortality by age.
abstract: OBJECTIVE
  It remains unclear whether the respective dose-response relationships between serum alanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT) levels and risk of mortality are consistent by age.
  
  
  METHODS
  We used sampled cohort data from the National Health Insurance Corporation to conduct a retrospective cohort study. A total of 313 252 participants who received medical health check-ups from 2002 to 2008 were assessed for risk of death according to serum ALT and GGT levels over an average of 6 years. The hazard ratios (HRs) for mortality were analysed with Cox proportional hazard model.
  
  
  RESULTS
  The crude mortality rate increased linearly with increasing serum ALT and GGT levels in adults aged <60 years. However, the all-cause mortality rate showed a J-shaped relationship with increasing serum ALT levels whereas all-cause mortality rate showed a linear relationship with increasing serum GGT levels in adults aged ≥60 years. The HR of death showed U-shaped relationships with increasing serum ALT levels in adults aged ≥60 years. On the contrary, the HR of death from any cause had a linear association with increasing serum GGT levels among all age groups.
  
  
  CONCLUSIONS
  In this study, U-shaped relationship patterns were demonstrated between serum ALT levels and risk for all-cause mortality in adults aged ≥60 years while serum GGT levels showed a linear relationship with risk for all-cause death. Very low levels of serum ALT in elderly patients suggest that they are at high risk of mortality.
authors.affiliation: Cancer Registration and Statistic Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea.
authors.forename: Chang-Mo
authors.initials: CM
authors.lastname: Oh
authors.affiliation: Cancer Registration and Statistic Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea.|Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.
authors.forename: Young-Joo
authors.initials: YJ
authors.lastname: Won
authors.affiliation: Cancer Registration and Statistic Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea.|Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.
authors.forename: Hyunsoon
authors.initials: H
authors.lastname: Cho
authors.affiliation: Cancer Registration and Statistic Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea.
authors.forename: Jong-Keun
authors.initials: JK
authors.lastname: Lee
authors.affiliation: Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.|Cancer Early Detection Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea.
authors.forename: Bo Young
authors.initials: BY
authors.lastname: Park
authors.affiliation: Cancer Information and Education Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea.
authors.forename: Jae Kwan
authors.initials: JK
authors.lastname: Jun
authors.affiliation: Department of Occupational and Environmental Medicine, International St. Mary's Hospital, Catholic Kwandong University, Gangneung, Korea.
authors.forename: Dong-Hee
authors.initials: DH
authors.lastname: Koh
authors.affiliation: Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.
authors.forename: Moran
authors.initials: M
authors.lastname: Ki
authors.affiliation: Cancer Registration and Statistic Branch, National Cancer Control Institute, National Cancer Center, Goyang, Korea.
authors.forename: Kyu-Won
authors.initials: KW
authors.lastname: Jung
authors.affiliation: Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea.
authors.forename: In-Hwan
authors.initials: IH
authors.lastname: Oh
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D002423:Cause of Death; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D016016:Proportional Hazards Models; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D005723:gamma-Glutamyltransferase / Q000097:blood*
chemical_list: D005723:gamma-Glutamyltransferase; D000410:Alanine Transaminase
keywords: Korea; age groups; alanine aminotransferase; cause of death; gamma-glutamyl transferase; mortality