ALT和GGT升高预测全因死亡率和肝癌在台湾的男性

StephenW

Hepatology International
October 2013, Volume 7, Issue 4, pp 1040-1049
Elevated ALT and GGT predict all-cause mortality and hepatocellular carcinoma in Taiwanese male: a case-cohort study

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


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.

StephenW

摘要
目的

有证据表明肝酶和死亡在西方国家的风险呈正相关，然而，在亚洲人群中的证据很少。我们调查了肝酶和总，心血管（ CVD ） ，癌症和肝细胞癌（HCC ）的免费癌症在基线台湾男性的队列死亡率之间的关联。
方法

从1996年到2003年， 54,751年龄40-80岁未患癌症的台湾男性完成了健康检查，并随访至2005年（ 5.8 ±2.5年的随访） 。随机队列3,961男被选为比较1,864男谁死。我们使用Cox比例风险回归模型来评估各种原因，丙氨酸氨基转移酶（ ALT），谷草转氨酶（AST ）和γ-谷氨酰转移酶（GGT ）相关的心血管疾病和癌症死亡率的风险。
结果

在这一人群中，较高水平的血清ALT ， AST和GGT均显著与全因死亡率相关[风险比（HR ） 1.2 ， 1.8和1.6的ALT ， AST和GGT ，均P < 0.05 ] ，癌症死亡率（HR 1.8-2.8 ）和肝癌死亡率（HR 5.5-36.1 ） 。 GGT显著与心血管疾病死亡率（HR 1.2 ）相关联。
结论

在自由的癌症在基线台湾男， ALT ， AST和GGT升高与全因死亡，所有的癌症和肝癌的死亡率，独立的传统危险因素的未来风险有关联，并且可以用来识别男性谁将会从中受益肝癌筛查。