Normal serum aminotransferase concentration and risk of mortality from liver diseases: prospective cohort study

[Guest guest]

BMJ 2004;328:983 (24 April), doi:10.1136/bmj.38050.593634.63 (published 17

March 2004)

Paper

Normal serum aminotransferase concentration and risk of mortality from liver

diseases: prospective cohort study

Hyeon Chang Kim, instructor1, Chung Mo Nam, associate professor1, Sun Ha

Jee, assistant professor2, Kwang Hyub Han, professor3, Dae Kyu Oh,

director4, Il Suh, professor1

1 Department of Preventive Medicine and Public Health, Yonsei University

College of Medicine, 134 Shinchon-Dong, Seodaemun-Gu, Seoul 120-752,

Republic of Korea, 2 Graduate School of Health Science and Management,

Yonsei University, Seoul, 3 Department of Internal Medicine, Yonsei

University College of Medicine, Seoul, 4 Bureau of Health Promotion,

Ministry of Health and Welfare, Republic of Korea

Correspondence to: I Suh isuh@...

Objective To examine the relation between the normal range of serum

aminotransferase concentration and mortality from liver disease.

Design Prospective cohort study.

Setting Korea Medical Insurance Corporation study with eight years' follow

up.

Participants 94 533 men and 47 522 women aged 35-59 years.

Main outcome measure Mortality from liver diseases according to death

certificate.

Results There was a positive association between the aminotransferase

concentration, even within normal range (35-40 IU/l), and mortality from

liver disease. Compared with the concentration < 20 IU/l, the adjusted

relative risks for an aspartate aminotransferase concentration of 20-29 IU/l

and 30-39 IU/l were 2.5 (95% confidence interval 2.0 to 3.0) and 8.0 (6.6 to

9.8) in men and 3.3 (1.7 to 6.4) and 18.2 (8.1 to 40.4) in women,

respectively, The corresponding risks for alanine aminotransferase were 2.9

(2.4 to 3.5) and 9.5 (7.9 to 11.5) in men and 3.8 (1.9 to 7.7) and 6.6 (1.5

to 25.6) in women, respectively. According to receiver operating

characteristic curves the best cut-off values for the prediction of liver

disease in men were 31 IU/l for aspartate aminotransferase and 30 IU/l for

alanine aminotransferase.

Conclusion People with slightly increased aminotransferase activity, but

still within the normal range, should be closely observed and further

investigated for liver diseases.

[Guest guest]

BMJ 2004;328:983 (24 April), doi:10.1136/bmj.38050.593634.63 (published 17

March 2004)

Paper

Normal serum aminotransferase concentration and risk of mortality from liver

diseases: prospective cohort study

Hyeon Chang Kim, instructor1, Chung Mo Nam, associate professor1, Sun Ha

Jee, assistant professor2, Kwang Hyub Han, professor3, Dae Kyu Oh,

director4, Il Suh, professor1

1 Department of Preventive Medicine and Public Health, Yonsei University

College of Medicine, 134 Shinchon-Dong, Seodaemun-Gu, Seoul 120-752,

Republic of Korea, 2 Graduate School of Health Science and Management,

Yonsei University, Seoul, 3 Department of Internal Medicine, Yonsei

University College of Medicine, Seoul, 4 Bureau of Health Promotion,

Ministry of Health and Welfare, Republic of Korea

Correspondence to: I Suh isuh@...

Objective To examine the relation between the normal range of serum

aminotransferase concentration and mortality from liver disease.

Design Prospective cohort study.

Setting Korea Medical Insurance Corporation study with eight years' follow

up.

Participants 94 533 men and 47 522 women aged 35-59 years.

Main outcome measure Mortality from liver diseases according to death

certificate.

Results There was a positive association between the aminotransferase

concentration, even within normal range (35-40 IU/l), and mortality from

liver disease. Compared with the concentration < 20 IU/l, the adjusted

relative risks for an aspartate aminotransferase concentration of 20-29 IU/l

and 30-39 IU/l were 2.5 (95% confidence interval 2.0 to 3.0) and 8.0 (6.6 to

9.8) in men and 3.3 (1.7 to 6.4) and 18.2 (8.1 to 40.4) in women,

respectively, The corresponding risks for alanine aminotransferase were 2.9

(2.4 to 3.5) and 9.5 (7.9 to 11.5) in men and 3.8 (1.9 to 7.7) and 6.6 (1.5

to 25.6) in women, respectively. According to receiver operating

characteristic curves the best cut-off values for the prediction of liver

disease in men were 31 IU/l for aspartate aminotransferase and 30 IU/l for

alanine aminotransferase.

Conclusion People with slightly increased aminotransferase activity, but

still within the normal range, should be closely observed and further

investigated for liver diseases.

[Guest guest]

BMJ 2004;328:983 (24 April), doi:10.1136/bmj.38050.593634.63 (published 17

March 2004)

Paper

Normal serum aminotransferase concentration and risk of mortality from liver

diseases: prospective cohort study

Hyeon Chang Kim, instructor1, Chung Mo Nam, associate professor1, Sun Ha

Jee, assistant professor2, Kwang Hyub Han, professor3, Dae Kyu Oh,

director4, Il Suh, professor1

1 Department of Preventive Medicine and Public Health, Yonsei University

College of Medicine, 134 Shinchon-Dong, Seodaemun-Gu, Seoul 120-752,

Republic of Korea, 2 Graduate School of Health Science and Management,

Yonsei University, Seoul, 3 Department of Internal Medicine, Yonsei

University College of Medicine, Seoul, 4 Bureau of Health Promotion,

Ministry of Health and Welfare, Republic of Korea

Correspondence to: I Suh isuh@...

Objective To examine the relation between the normal range of serum

aminotransferase concentration and mortality from liver disease.

Design Prospective cohort study.

Setting Korea Medical Insurance Corporation study with eight years' follow

up.

Participants 94 533 men and 47 522 women aged 35-59 years.

Main outcome measure Mortality from liver diseases according to death

certificate.

Results There was a positive association between the aminotransferase

concentration, even within normal range (35-40 IU/l), and mortality from

liver disease. Compared with the concentration < 20 IU/l, the adjusted

relative risks for an aspartate aminotransferase concentration of 20-29 IU/l

and 30-39 IU/l were 2.5 (95% confidence interval 2.0 to 3.0) and 8.0 (6.6 to

9.8) in men and 3.3 (1.7 to 6.4) and 18.2 (8.1 to 40.4) in women,

respectively, The corresponding risks for alanine aminotransferase were 2.9

(2.4 to 3.5) and 9.5 (7.9 to 11.5) in men and 3.8 (1.9 to 7.7) and 6.6 (1.5

to 25.6) in women, respectively. According to receiver operating

characteristic curves the best cut-off values for the prediction of liver

disease in men were 31 IU/l for aspartate aminotransferase and 30 IU/l for

alanine aminotransferase.

Conclusion People with slightly increased aminotransferase activity, but

still within the normal range, should be closely observed and further

investigated for liver diseases.

[Guest guest]

BMJ 2004;328:983 (24 April), doi:10.1136/bmj.38050.593634.63 (published 17

March 2004)

Paper

Normal serum aminotransferase concentration and risk of mortality from liver

diseases: prospective cohort study

Hyeon Chang Kim, instructor1, Chung Mo Nam, associate professor1, Sun Ha

Jee, assistant professor2, Kwang Hyub Han, professor3, Dae Kyu Oh,

director4, Il Suh, professor1

1 Department of Preventive Medicine and Public Health, Yonsei University

College of Medicine, 134 Shinchon-Dong, Seodaemun-Gu, Seoul 120-752,

Republic of Korea, 2 Graduate School of Health Science and Management,

Yonsei University, Seoul, 3 Department of Internal Medicine, Yonsei

University College of Medicine, Seoul, 4 Bureau of Health Promotion,

Ministry of Health and Welfare, Republic of Korea

Correspondence to: I Suh isuh@...

Objective To examine the relation between the normal range of serum

aminotransferase concentration and mortality from liver disease.

Design Prospective cohort study.

Setting Korea Medical Insurance Corporation study with eight years' follow

up.

Participants 94 533 men and 47 522 women aged 35-59 years.

Main outcome measure Mortality from liver diseases according to death

certificate.

Results There was a positive association between the aminotransferase

concentration, even within normal range (35-40 IU/l), and mortality from

liver disease. Compared with the concentration < 20 IU/l, the adjusted

relative risks for an aspartate aminotransferase concentration of 20-29 IU/l

and 30-39 IU/l were 2.5 (95% confidence interval 2.0 to 3.0) and 8.0 (6.6 to

9.8) in men and 3.3 (1.7 to 6.4) and 18.2 (8.1 to 40.4) in women,

respectively, The corresponding risks for alanine aminotransferase were 2.9

(2.4 to 3.5) and 9.5 (7.9 to 11.5) in men and 3.8 (1.9 to 7.7) and 6.6 (1.5

to 25.6) in women, respectively. According to receiver operating

characteristic curves the best cut-off values for the prediction of liver

disease in men were 31 IU/l for aspartate aminotransferase and 30 IU/l for

alanine aminotransferase.

Conclusion People with slightly increased aminotransferase activity, but

still within the normal range, should be closely observed and further

investigated for liver diseases.