Elevated liver enzymes and cardiovascular mortality
a systematic review and dose–response meta-analysis of more than one million participants
Rahmani, Jamala; Miri, Alif; Namjoo, Imang; Zamaninour, Negarc; Maljaei, Mohammad B.d, h; Zhou, Kehuai; Cerneviciute, Ramintaj; Mousavi, Seyed M.e; Varkaneh, Hamed K.b; Salehisahlabadi, Ammarb; Zhang, Yongk
European Journal of Gastroenterology & Hepatology: May 2019 - Volume 31 - Issue 5 - p 555–562
Doi: 10.1097/MEG.0000000000001353
Review Article
Gamma glutamyl transferase (GGT), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) are commonly used liver function markers. We performed a dose–response meta-analysis to investigate the association between liver enzymes and cardiovascular Disease (CVD) mortality in prospective cohort studies. We conducted a systematic search up to April 2018 in Medline/PubMed, Scopus, Cochrane, and Embase databases. Combined hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using a Twenty-three studies with 1 067 922 participants reported association between GGT and CVD mortality and were included in our analysis. Pooled results showed a significant association between GGT and risk of CVD mortality (HR: 1.62; 95% CI: 1.47–1.78, P=0.001, P-heterogeneity=0.001) and it was HR: 0.87; 95% CI: 0.73–1.07; P=0.221, P- Heterogen Eity=0.028, for ALT. There was a direct association between baseline levels of ALP and AST/ALT ratio with CVD mortality (HR: 1.45; 95% CI: 1.11–1.89; P=0.005, P-heterogeneity=0.026, and HR : </ RTI> <RTIgt; -1.73; P=0.313, P-heterogeneity=0.024). Moreover, there was a significant nonlinear association between GGT and ALP levels and the risk of CVD mortality (P=0.008 and 0.016, respectively). Our dose–response meta-analysis High level of GGT, ALP and AST/ALT were associated with an increased CVD mortality rate.作者: StephenW 时间: 2019-4-2 10:42