Circulating levels of liver enzymes and incidence of atrial fibrillation: the Atherosclerosis Risk in Communities cohort.
Circulating levels of liver enzymes and incidence of atrial fibrillation: the Atherosclerosis Risk in Communities cohort.
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DOI：
10.1136/heartjnl-2014-305756
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发表时间：
2014-10
期刊：
影响因子：
--
通讯作者：
Selvin E
中科院分区：
文献类型：
--
作者：
Alonso A;Misialek JR;Amiin MA;Hoogeveen RC;Chen LY;Agarwal SK;Loehr LR;Soliman EZ;Selvin E
循环中的肝酶水平升高与心血管疾病风险增加有关。它们可能与房颤(房颤)的关系尚未引起足够的重视。我们研究了9333名男性和女性，年龄53-75岁，没有房颤，参加了1996年至2010年的社区动脉粥样硬化风险跟踪研究。测定保存血浆中天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、丙氨酸氨基转移酶(GGT)。房颤事件是从住院和死亡证明中确定的。使用多变量COX比例风险模型评估肝酶与房颤发生率之间的关系。在平均12年的随访中，1021个事件的房颤事件被确定。在最小调整模型中，AST水平和ALT水平与房颤风险呈U型相关，在分布的两个极端的个体中房颤风险更高。在对潜在的混杂因素进行调整后，这些关联被削弱了。相反，以对数为底数2建模的GGT在多变量调整后与房颤风险呈线性相关：GGT水平翻倍与房颤风险增加20%(95%可信区间，10-30%)。对炎症标志物的额外调整对结果没有明显影响。在男性和女性、白人和黑人、从不饮酒的人和那些没有普遍心力衰竭的人中，这种关联没有什么不同。在这项基于社区的前瞻性研究中，肝酶水平较高，主要是GGT，与房颤风险增加相关。这种联系背后的机制值得进一步审查。
Elevated levels of circulating liver enzymes have been associated with increased risk of cardiovascular disease. Their possible association with atrial fibrillation (AF) has received little attention. We studied 9333 men and women, age 53–75, free of AF participating in the Atherosclerosis Risk in Communities Study followed up from 1996 to 2010. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma glutamyl transpeptidase (GGT) were measured in stored plasma samples. Incident AF was ascertained from hospitalizations and death certificates. Associations between liver enzymes and AF incidence were assessed using multivariable Cox proportional hazards models. During a mean follow-up of 12 years, 1021 incident AF events were identified. Levels of AST, and to a lesser extent of ALT, showed a U-shaped association with AF risk, with higher AF risk among individuals in the two extremes of the distribution in minimally adjusted models. The associations were weakened after adjustment for potential confounders. In contrast, GGT, modeled as log base 2, was linearly associated with AF risk after multivariable adjustment: a doubling of GGT levels was associated with a 20% increased risk of AF (95% confidence interval, 10–30%). Additional adjustment for inflammatory markers did not appreciably affect the results. Associations were not different in men and women, in whites and blacks, among never drinkers of alcohol, and among those without prevalent heart failure. In this community-based prospective study, higher levels of liver enzymes, mainly GGT, were associated with an increased risk of AF. The mechanisms underlying this association deserve further scrutiny.
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影响因子：
37.8
作者：
Huxley RR;Lopez FL;Folsom AR;Agarwal SK;Loehr LR;Soliman EZ;Maclehose R;Konety S;Alonso A
通讯作者：
Alonso A
影响因子：
3.7
作者：
Seymour, Christopher W.;Cooke, Colin R.;Pepe, Margaret S.
通讯作者：
Pepe, Margaret S.
影响因子：
37.8
作者：
Magnani, Jared W.;Rienstra, Michiel;Benjamin, Emelia J.
通讯作者：
Benjamin, Emelia J.
影响因子：
8.3
作者：
Soliman EZ;Prineas RJ;Case LD;Zhang ZM;Goff DC Jr
通讯作者：
Goff DC Jr
影响因子：
5.4
作者：
Alonso A;Krijthe BP;Aspelund T;Stepas KA;Pencina MJ;Moser CB;Sinner MF;Sotoodehnia N;Fontes JD;Janssens AC;Kronmal RA;Magnani JW;Witteman JC;Chamberlain AM;Lubitz SA;Schnabel RB;Agarwal SK;McManus DD;Ellinor PT;Larson MG;Burke GL;Launer LJ;Hofman A;Levy D;Gottdiener JS;Kääb S;Couper D;Harris TB;Soliman EZ;Stricker BH;Gudnason V;Heckbert SR;Benjamin EJ
通讯作者：
Benjamin EJ