肝酶升高和心血管死亡率升高 超过一百万参与者的系统评价

StephenW

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.

StephenW

肝酶升高和心血管死亡率升高
超过一百万参与者的系统评价和剂量反应荟萃分析

拉赫马尼，贾马拉;美里，阿里夫; Namjoo，Imang; Zamaninour，Negarc; Maljaei，Mohammad B.d，h;周克怀; Cerneviciute，Ramintaj; Mousavi，Seyed M.e; Varkaneh，Hamed K.b; Salehisahlabadi，Ammarb;张永克
欧洲胃肠病学和肝病学杂志：2019年5月 - 第31卷 - 第5期 - 第555-562页
Doi：10.1097 / MEG.0000000000001353
评论文章


γ-谷氨酰转移酶（GGT），丙氨酸氨基转移酶（ALT），天冬氨酸氨基转移酶（AST）和碱性磷酸酶（ALP）是常用的肝功能标记物。我们进行了剂量反应荟萃分析，以研究前瞻性队列研究中肝酶与心血管疾病（CVD）死亡率之间的关系。我们在Medline / PubMed，Scopus，Cochrane和Embase数据库中对2018年4月进行了系统检索。综合风险比（HRs）与95％置信区间（CIs）使用23项研究进行估计，其中1 067 922名参与者报告了GGT与CVD死亡率之间的关联，并纳入我们的分析。汇总结果显示GGT与CVD死亡风险之间存在显着相关性（HR：1.62; 95％CI：1.47-1.78，P = 0.001，P-异质性= 0.001），HR为0.87; 95％CI：0.73-1.07;对于ALT，P = 0.221，P-杂原子Eity = 0.028。 ALP基线水平和AST / ALT比率与CVD死亡率之间存在直接关联（HR：1.45; 95％CI：1.11-1.89; P = 0.005，P-异质性= 0.026，HR： ; -1.73; P = 0.313，P-异质性= 0.024）。此外，GGT和ALP水平与CVD死亡风险之间存在显着的非线性关联（分别为P = 0.008和0.016）。我们的剂量反应荟萃分析高水平的GGT，ALP和AST / ALT与CVD死亡率增加有关。