Serum aminotransferase activity and mortality risk in a United States community
Serum aminotransferase activity and mortality risk in a United States community
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DOI：
10.1002/hep.22090
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发表时间：
2008-03-01
期刊：
影响因子：
13.5
通讯作者：
Melton, L. Joseph, III
中科院分区：
文献类型：
--
作者：
Lee, Tae Hoon;Kim, W. Ray;Melton, L. Joseph, III
血清转氨酶[如天冬氨酸转氨酶（AST）和丙氨酸转氨酶（ALT）]通常用作肝脏疾病的指标。本研究的目的是确定转氨酶结果与人群水平死亡率增加相关的程度。对1995年在罗切斯特的马约诊所接受医疗保健的明尼苏达州奥姆斯特德县的所有成年居民进行了识别，并从实验室数据库中提取了他们的AST或ALT结果。从1995年1月至2006年4月对这些受试者进行了随访，并确定了他们的生存率。为了排除因晚期疾病导致结果异常的患者，排除了前2年内的死亡。主要的结局指标是生存率。根据明尼苏达州白色人的死亡率计算标准化死亡率（SMR）。1995年期间，18，401名社区居民至少测量了一次AST，其中2，350名（13%）的结果大于正常上限（ULN）。在测量ALT的6，823例受试者中，911例（13%）的结果高于ULN。AST异常与SMR显著增加相关（1-2 × ULN为1.32，> 2 × ULN为1.78）。ALT异常的SMR也较高（1-2 × ULN的SMR = 1.21，> 2 × ULN的SMR = 1.51）。相反，正常的AST或ALT与低于预期的死亡风险相关（AST SMR 0.95，ALT SMR 0.61）。结论：在常规医疗保健环境中获得的血清AST和ALT水平与社区居民的未来死亡率相关。
Serum aminotransferase [such as aspartate aminotransferase (AST) and alanine aminotransferase (ALT)] is commonly used as an indicator of liver disease. The aim of the study was to determine the degree to which aminotransferase results are associated with increased mortality at the population level. All adult residents of Olmsted County, Minnesota, who had a health care encounter at Mayo Clinic, Rochester, in 1995 were identified and their AST or ALT results extracted from a laboratory database. These subjects were followed forward from January 1995 to April 2006 and their survival determined. To exclude patients with abnormal results because of a terminal illness, deaths within the first 2 years were excluded. The main outcome measure was survival. Standardized mortality ratios (SMRs) were calculated, based on Minnesota White death rates. During 1995, AST was measured at least once in 18,401 community residents, of whom 2,350 (13%) had results greater than the upper limit of normal (ULN). Of 6,823 subjects who had their ALT measured, 911 (13%) had results higher than ULN. Abnormal AST was associated with a significantly increased SMR (1.32 for 1-2 X ULN and 1.78 for > 2 X ULN). SMR was also higher for abnormal ALT (SMR = 1.21 for 1-2 X ULN and 1.51 for > 2 X ULN). In contrast, normal AST or ALT was associated with a risk of death lower than expected (SMR 0.95 for AST, 0.61 for ALT). Conclusion: Serum levels of AST and ALT obtained in a routine medical care setting are associated with future mortality in community residents.