Normal serum aminotransferase concentration and risk of mortality from liver diseases: prospective cohort study
Normal serum aminotransferase concentration and risk of mortality from liver diseases: prospective cohort study
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DOI：
10.1136/bmj.38050.593634.63
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发表时间：
2004-04-24
影响因子：
105.7
通讯作者：
Suh, I
中科院分区：
文献类型：
--
作者：
Kim, HC;Nam, CM;Suh, I
目的 探讨血清转氨酶 0 浓度正常值与肝病死亡率之间的关系。设计前瞻性队列研究。以韩国医疗保险公司为研究对象，随访 8 年。参与者 94 533 名男性和 47 522 名女性，年龄 35-59 岁。主要结果根据死亡证明衡量肝病死亡率。结果 即使在正常范围内（35-40 岁），转氨酶浓度之间也存在正相关关系。 IU/I) 和肝病死亡率。与浓度 < 20 IU/I 相比，天冬氨酸转氨酶浓度为 20-29 IU/I 和 30-39 IU/I 的调整后相对风险，男性为 2.5（95% 置信区间 2.0 至 3.0）和 8.0（6.6 至 9.8），男性为 3.3（1.7 至 6.4）和 18.2（8.1 至 9.8）。女性丙氨酸氨基转移酶的相应风险分别为 40.4），男性丙氨酸氨基转移酶的相应风险分别为 2.9（2.4 至 3.5）和 9.5（7.9 至 11.5），女性分别为 3.8（1.9 至 7.7）和 6.6（1.5 至 25.6） 根据受试者工作特征曲线，预测男性肝病的最佳临界值是 31 IU/I天冬氨酸转氨酶、丙氨酸转氨酶30 IU/I。结论转氨酶活性轻度升高但仍在正常范围内的人群，应密切观察并进一步排查是否有肝脏疾病。
Objective To examine the relation between the normal nano-e of serum aminotransferase 0 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/I), and mortality from liver disease. Compared with the concentration < 20 IU/I, the adjusted relative risks for an aspartate aminotransferase concentration of 20-29 IU/I and 30-39 IU/I 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/I for aspartate aminotransferase and 30 IU/I 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.