Tags

Type your tag names separated by a space and hit enter

Elevated serum alanine aminotransferase and gamma-glutamyltransferase and mortality in the United States population.
Gastroenterology 2009; 136(2):477-85.e11G

Abstract

BACKGROUND & AIMS

Elevated serum alanine aminotransferase (ALT) and gamma-glutamyltransferase (GGT) activities are markers of liver injury, but may also be associated with other diseases and death. In a prospective, national, population-based sample, we examined whether elevated ALT and GGT were associated with increased risk of all-cause and disease-specific mortality.

METHODS

Death certificate-based 12-year mortality was analyzed among 14,950 adult participants in the third US National Health and Nutrition Examination Survey, 1988-1994, who were negative for markers of viral hepatitis B and C. Abnormal ALT was defined as >30 U/L in men or >19 U/L in women, and abnormal GGT as >51 U/L in men or >33 U/L in women.

RESULTS

Cumulative mortality was 13.9% from all causes, including 4.2% from cardiovascular disease, 4.2% from neoplasms, 0.44% from diabetes, and 0.13% from liver disease. In multivariate-adjusted analyses, elevated ALT was not associated with all-cause mortality (hazard ratio [HR], 1.2; 95% confidence interval [CI], 0.88-1.6). ALT elevation was associated with deaths from liver disease (HR, 8.2; 95% CI, 2.1-31.9), but not from cardiovascular disease (HR, 0.90; 95% CI, 0.56-1.4), neoplasms (HR, 1.0; 95% CI, 0.65-1.5), or diabetes (HR, 2.4; 95% CI, 0.65-9.1). All-cause mortality increased with elevated GGT (HR, 1.5; 95% CI, 1.2-1.8), as did mortality from liver disease (HR, 13.0; 95% CI, 2.4-71.5), neoplasms (HR, 1.5; 95% CI, 1.01-2.2), and diabetes (HR, 3.3; 95% CI, 1.4-7.6), but not from cardiovascular disease (HR, 1.3; 95% CI, 0.80-2.0).

CONCLUSIONS

In the US population, elevated GGT was associated with mortality from all causes, liver disease, cancer, and diabetes, while ALT was associated only with liver disease mortality.

Authors+Show Affiliations

Social & Scientific Systems, Inc, Silver Spring, Maryland 20910, USA. cruhl@s-3.comNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

19100265

Citation

Ruhl, Constance E., and James E. Everhart. "Elevated Serum Alanine Aminotransferase and Gamma-glutamyltransferase and Mortality in the United States Population." Gastroenterology, vol. 136, no. 2, 2009, pp. 477-85.e11.
Ruhl CE, Everhart JE. Elevated serum alanine aminotransferase and gamma-glutamyltransferase and mortality in the United States population. Gastroenterology. 2009;136(2):477-85.e11.
Ruhl, C. E., & Everhart, J. E. (2009). Elevated serum alanine aminotransferase and gamma-glutamyltransferase and mortality in the United States population. Gastroenterology, 136(2), pp. 477-85.e11. doi:10.1053/j.gastro.2008.10.052.
Ruhl CE, Everhart JE. Elevated Serum Alanine Aminotransferase and Gamma-glutamyltransferase and Mortality in the United States Population. Gastroenterology. 2009;136(2):477-85.e11. PubMed PMID: 19100265.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Elevated serum alanine aminotransferase and gamma-glutamyltransferase and mortality in the United States population. AU - Ruhl,Constance E, AU - Everhart,James E, Y1 - 2008/10/29/ PY - 2008/04/21/received PY - 2008/09/18/revised PY - 2008/10/09/accepted PY - 2008/12/23/entrez PY - 2008/12/23/pubmed PY - 2009/3/3/medline SP - 477 EP - 85.e11 JF - Gastroenterology JO - Gastroenterology VL - 136 IS - 2 N2 - BACKGROUND & AIMS: Elevated serum alanine aminotransferase (ALT) and gamma-glutamyltransferase (GGT) activities are markers of liver injury, but may also be associated with other diseases and death. In a prospective, national, population-based sample, we examined whether elevated ALT and GGT were associated with increased risk of all-cause and disease-specific mortality. METHODS: Death certificate-based 12-year mortality was analyzed among 14,950 adult participants in the third US National Health and Nutrition Examination Survey, 1988-1994, who were negative for markers of viral hepatitis B and C. Abnormal ALT was defined as >30 U/L in men or >19 U/L in women, and abnormal GGT as >51 U/L in men or >33 U/L in women. RESULTS: Cumulative mortality was 13.9% from all causes, including 4.2% from cardiovascular disease, 4.2% from neoplasms, 0.44% from diabetes, and 0.13% from liver disease. In multivariate-adjusted analyses, elevated ALT was not associated with all-cause mortality (hazard ratio [HR], 1.2; 95% confidence interval [CI], 0.88-1.6). ALT elevation was associated with deaths from liver disease (HR, 8.2; 95% CI, 2.1-31.9), but not from cardiovascular disease (HR, 0.90; 95% CI, 0.56-1.4), neoplasms (HR, 1.0; 95% CI, 0.65-1.5), or diabetes (HR, 2.4; 95% CI, 0.65-9.1). All-cause mortality increased with elevated GGT (HR, 1.5; 95% CI, 1.2-1.8), as did mortality from liver disease (HR, 13.0; 95% CI, 2.4-71.5), neoplasms (HR, 1.5; 95% CI, 1.01-2.2), and diabetes (HR, 3.3; 95% CI, 1.4-7.6), but not from cardiovascular disease (HR, 1.3; 95% CI, 0.80-2.0). CONCLUSIONS: In the US population, elevated GGT was associated with mortality from all causes, liver disease, cancer, and diabetes, while ALT was associated only with liver disease mortality. SN - 1528-0012 UR - https://www.unboundmedicine.com/medline/citation/19100265/Elevated_serum_alanine_aminotransferase_and_gamma_glutamyltransferase_and_mortality_in_the_United_States_population_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0016-5085(08)01890-8 DB - PRIME DP - Unbound Medicine ER -