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Hernaez R, Yeh HC, Lazo M, et al. Elevated ALT and GGT predict all-cause mortality and hepatocellular carcinoma in Taiwanese male: a case-cohort study. Hepatol Int. 2013;7(4):1040-9doi: 10.1007/s12072-013-9476-6.
Hernaez, R., Yeh, H. C., Lazo, M., Chung, H. M., Hamilton, J. P., Koteish, A., Potter, J. J., Brancati, F. L., & Clark, J. M. (2013). Elevated ALT and GGT predict all-cause mortality and hepatocellular carcinoma in Taiwanese male: a case-cohort study. Hepatology international, 7(4), 1040-9. https://doi.org/10.1007/s12072-013-9476-6
Hernaez, Ruben, et al. "Elevated ALT and GGT predict all-cause mortality and hepatocellular carcinoma in Taiwanese male: a case-cohort study." Hepatology international vol. 7,4 (2013): 1040-9. doi: https://doi.org/10.1007/s12072-013-9476-6
Hernaez R, Yeh HC, Lazo M, Chung HM, Hamilton JP, Koteish A, Potter JJ, Brancati FL, Clark JM. Elevated ALT and GGT predict all-cause mortality and hepatocellular carcinoma in Taiwanese male: a case-cohort study. Hepatol Int. 2013 Oct;7(4):1040-9. doi: 10.1007/s12072-013-9476-6. Epub 2013 Oct 17. PMID: 26202033.
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Hepatol Int. 2013 Oct;7(4):1040-9. doi: 10.1007/s12072-013-9476-6. Epub 2013 Oct 17.

Elevated ALT and GGT predict all-cause mortality and hepatocellular carcinoma in Taiwanese male: a case-cohort study.

Hepatology international

Ruben Hernaez, Hsin-Chieh Yeh, Mariana Lazo, Hui-Ming Chung, James P Hamilton, Ayman Koteish, James J Potter, Frederick L Brancati, Jeanne M Clark

Affiliations

  1. Department of Medicine, The Johns Hopkins School of Medicine, 2024 East Monument Street, Suite 2-600, Baltimore, MD, 21287, USA. [email protected].
  2. Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. [email protected].
  3. Department of Medicine, The Johns Hopkins School of Medicine, 2024 East Monument Street, Suite 2-600, Baltimore, MD, 21287, USA. [email protected].
  4. Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. [email protected].
  5. Welch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins University, Baltimore, MD, USA. [email protected].
  6. Department of Medicine, The Johns Hopkins School of Medicine, 2024 East Monument Street, Suite 2-600, Baltimore, MD, 21287, USA. [email protected].
  7. Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. [email protected].
  8. Welch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins University, Baltimore, MD, USA. [email protected].
  9. Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. [email protected].
  10. Department of Medical Research, Mennonite Christian Hospital, Hualian City, Taiwan. [email protected].
  11. Department of Medicine, The Johns Hopkins School of Medicine, 2024 East Monument Street, Suite 2-600, Baltimore, MD, 21287, USA. [email protected].
  12. Department of Medicine, The Johns Hopkins School of Medicine, 2024 East Monument Street, Suite 2-600, Baltimore, MD, 21287, USA. [email protected].
  13. Department of Medicine, The Johns Hopkins School of Medicine, 2024 East Monument Street, Suite 2-600, Baltimore, MD, 21287, USA. [email protected].
  14. Department of Medicine, The Johns Hopkins School of Medicine, 2024 East Monument Street, Suite 2-600, Baltimore, MD, 21287, USA. [email protected].
  15. Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. [email protected].
  16. Welch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins University, Baltimore, MD, USA. [email protected].
  17. Department of Medicine, The Johns Hopkins School of Medicine, 2024 East Monument Street, Suite 2-600, Baltimore, MD, 21287, USA. [email protected].
  18. Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. [email protected].
  19. Welch Center for Prevention, Epidemiology and Clinical Research, The Johns Hopkins University, Baltimore, MD, USA. [email protected].

PMID: 26202033 DOI: 10.1007/s12072-013-9476-6

Abstract

PURPOSE: Evidence indicates a positive association between liver enzymes and the risk of death in Western countries; however, the evidence in Asian populations is scarce. We investigated the association between liver enzymes and total, cardiovascular (CVD), cancer and hepatocellular carcinoma (HCC) mortality in a cohort of Taiwanese male free of cancer at baseline.

METHODS: From 1996 to 2003, 54,751 Taiwanese male aged 40-80 years without cancer completed a health screening and were followed through 2005 (5.8 ± 2.5 years of follow-up). A random cohort of 3,961 male was selected to compare to 1,864 male who died. We used Cox proportional hazards regression models to assess the risk of all-cause, cardiovascular and cancer mortality associated with alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma glutamyl transferase (GGT).

RESULTS: In this population, higher levels of ALT, AST and GGT were significantly associated with all-cause mortality [hazard ratio (HR) 1.2, 1.8 and 1.6 for ALT, AST and GGT, respectively; all p < 0.05], cancer mortality (HR 1.8-2.8) and HCC mortality (HR 5.5-36.1). GGT was significantly associated with CVD mortality (HR 1.2).

CONCLUSIONS: In Taiwanese male free of cancer at baseline, elevations of ALT, AST and GGT were associated with future risk of all-cause death, all cancer and HCC mortality, independent of conventional risk factors, and could be used to identify male who would benefit from HCC screening.

Keywords: Asia; Checkup; Hazard ratio; Longitudinal study; Nonalcoholic fatty liver disease

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