Implication of liver enzymes on incident cardiovascular diseases and mortality: A nationwide population-based cohort study

• Published in: Scientific reports Vol. 8; no. 1; pp. 3764 - 9
• Main Authors: Choi, Kyung Mook, Han, Kyungdo, Park, Sanghyun, Chung, Hye Soo, Kim, Nam Hoon, Yoo, Hye Jin, Seo, Ji-A, Kim, Sin Gon, Kim, Nan Hee, Baik, Sei Hyun, Park, Yong Gyu, Kim, Seon Mee
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 28.02.2018; Nature Publishing Group
• Subjects: 692/163/2743/2037; 692/4020/4021/1607/2750; Adult; Aged; Alanine; Alanine transaminase; Aspartate aminotransferase; Cardiovascular diseases; Cardiovascular Diseases - enzymology; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - mortality; Cerebral infarction; Cohort analysis; Cohort Studies; Databases, Factual; Enzymes; Female; Health risk assessment; Health risks; Humanities and Social Sciences; Humans; Incidence; Ischemia; Life Style; Liver; Liver - enzymology; Male; Middle Aged; Mortality; multidisciplinary; Myocardial infarction; Population studies; Population-based studies; Republic of Korea - epidemiology; Risk Factors; Science; Science (multidisciplinary); Transferases - metabolism; Young Adult; Republic of Korea
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-018-19700-8

Although liver enzymes, such as γ-glutamyltransferase (GGT), alanine aminotransferase (ALT), and aspartate aminotransferase (AST), have recently been suggested as risk factors for cardiovascular diseases (CVD), impact on mortality after myocardial infarction (MI) or ischemic stroke (IS) was not previously examined. Using a population-based, nationwide cohort database, we explored the implication of GGT and aminotransferases on the development of CVD and all-cause mortality during a median 9.1 years of follow-up. Among 16,624,006 Korean adults, both GGT and aminotransferases exhibited a positive relationship with MI, IS, and mortality in a multivariate adjusted model. ALT and AST showed U-shaped associations with mortality, whereas GGT showed a positive linear relationship with mortality. The risk of 1-year mortality after MI or IS was significantly higher in the highest quartile of GGT compared to the lowest quartile (HR, 1.46; 95% CI, 1.40-1.52). The implication of GGT on MI, IS, and mortality persisted regardless of traditional cardiovascular risk parameters. This study demonstrated the unique pattern of association of ALT, AST, and GGT with the development of CVD and all-cause mortality in the Korean population. In particular, GGT showed the most robust linear relationship with mortality before and after cardiovascular events independent of risk factors.