title: Association Between Change in Serum Aminotransferase and Mortality: A Nationwide Cohort Study in Korea.
abstract: There is little information on how the change in serum aminotransferase affects mortality. We investigated the association between changes in serum aminotransferase levels and mortality from all causes, cardiovascular disease (CVD), and liver disease.Three percent of men from the Korean National Health Insurance database were sampled randomly at the end of 2002. After excluding patients with cancer, CVD, CVD risk factors, or liver disease, those who participated in 2 consecutive rounds of the national health screening examination were included (n = 68,431). The primary outcome was CVD mortality. Secondary outcomes were liver disease mortality and all-cause mortality. Change in metabolic profiles was analyzed based on changes in liver enzyme levels. Elevated levels of serum aminotransferase were associated with CVD, liver disease, and all-cause mortality. Men who had sustained elevation of serum aminotransferase during 2 subsequent liver enzyme tests showed a significantly higher risk of CVD mortality (adjusted hazard ratio [aHR] 1.95; 95% confidence interval [CI] 1.07-3.56, 2.29; 1.27-4.12) than the sustained normal group. In contrast, the normalization group (aHR 1.52, 95% CI 0.82-2.81 for aspartate aminotransferase [AST]; aHR 1.35, 95% CI 0.70-2.61 for alanine aminotransferase [ALT]) and the new elevation group (aHR 1.27, 0.66-2.44 for AST; aHR 0.99, 95% CI 0.49-2.20 for ALT) were not different from the sustained normal group in CVD mortality.Individuals with serum aminotransferase elevation, particularly when sustained, are at higher risk of mortality, and should receive appropriate medical attention.
authors.affiliation: From the Department of Family Medicine and Health Promotion Center (HL, DWS, EA, J-MY, H-KL, BS, KYS, JSK, BC), Seoul National University Hospital; Department of Family Medicine (DWS, BC), College of Medicine, Seoul National University, Seoul, Korea; Division of Gastroenterology and Hepatology (THL), Metro Health Medical Center, Case Western Reserve University, Cleveland, OH; and Cancer Policy Branch (H-KY), National Cancer Control Institute, National Cancer Center, Goyang, Korea.
authors.forename: Hyejin
authors.initials: H
authors.lastname: Lee
authors.forename: Dong Wook
authors.initials: DW
authors.lastname: Shin
authors.forename: Tae Hoon
authors.initials: TH
authors.lastname: Lee
authors.forename: Hyung-Kook
authors.initials: HK
authors.lastname: Yang
authors.forename: Eunmi
authors.initials: E
authors.lastname: Ahn
authors.forename: Jae-Moon
authors.initials: JM
authors.lastname: Yoon
authors.forename: Hyun-Ki
authors.initials: HK
authors.lastname: Lee
authors.forename: Beomseok
authors.initials: B
authors.lastname: Suh
authors.forename: Ki Young
authors.initials: KY
authors.lastname: Son
authors.forename: Jun Suk
authors.initials: JS
authors.lastname: Kim
authors.forename: BeLong
authors.initials: B
authors.lastname: Cho
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D002318:Cardiovascular Diseases / Q000201:enzymology* / Q000401:mortality*; D002423:Cause of Death; D015331:Cohort Studies; D006306:Health Surveys; D006801:Humans; D008107:Liver Diseases / Q000201:enzymology* / Q000401:mortality*; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D056910:Republic of Korea; D012307:Risk Factors; D016019:Survival Analysis; D000637:Transaminases / Q000097:blood*
chemical_list: D015415:Biomarkers; D000637:Transaminases