Circulating liver function markers and the risk of COPD in the UK Biobank

Abstract

ObjectiveTo investigate the associations of circulating liver function marker levels with the risk of chronic obstructive pulmonary disease (COPD).MethodsWe leveraged the data of 372,056 participants from the UK Biobank between 2006 and 2010. The assessed circulating liver function markers included alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), total bilirubin (TBIL), albumin (ALB), and total protein (TP). Incident COPD was identified through linkage to the National Health Service registries. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).ResultsDuring a median follow-up period of 12.3 (interquartile range:11.4-13.2) years, we documented 10,001 newly diagnosed COPD cases. Lower levels of ALT, TBIL, ALB, and TP and higher levels of GGT and ALP were nonlinearly associated with elevated COPD risk. The HR (95% CI) for decile 10 vs. 1 was 0.92 (0.84-1.01) for ALT, 0.82 (0.75-0.89) for TBIL, 0.74 (0.67-0.81) for ALB, 0.96 (0.88-1.04) for TP, 1.45 (1.31-1.62) for GGT, and 1.31 (1.19-1.45) for ALP. Restricted cubic spline analyses suggested a U-shaped relationship between AST levels and COPD risk (P for nonlinearity <0.05).ConclusionWe observed that all seven circulating liver function markers were nonlinearly associated with the risk of COPD, indicating the importance of liver function in COPD.

Association and biological pathways between lung function and incident depression: a prospective cohort study of 280,032 participants

“…Specifically, low lung function that disrupts the exchange of oxygen and carbon dioxide could engender both conditions [ 38 ], causing metabolic dysregulation in brain cells and ultimately triggering depressive symptoms [ 39 ]. Moreover, the increased risk of depression ascribed to impaired lung function might be partially explained by the deterioration in the liver and renal functions, in line with prior studies [ 13 , 14 , 40 , 41 ]. For instance, a cohort study involving more than 370,000 participants revealed a significant association between liver function markers, such as ALT, TBIL, ALB, TP, GGT, and ALP, and an elevated risk of lung disease [ 13 ].…”

“…Moreover, the increased risk of depression ascribed to impaired lung function might be partially explained by the deterioration in the liver and renal functions, in line with prior studies [ 13 , 14 , 40 , 41 ]. For instance, a cohort study involving more than 370,000 participants revealed a significant association between liver function markers, such as ALT, TBIL, ALB, TP, GGT, and ALP, and an elevated risk of lung disease [ 13 ]. Also, a MR study supported a causal relationship between lung diseases and renal function [ 14 ].…”

“…Based on the evidence of potential pathways [ 13 – 18 ], 25 blood biomarkers including inflammation, erythrocytes, liver and renal function, and 168 plasma metabolites were selected as potential mediators. In the UKB, blood tests were performed on participants with informed consent at baseline recruitment.…”

“…Existing epidemiological studies have established links between abnormal lung function and various biomarkers, including liver [ 13 ], kidney [ 14 ], erythrocytes [ 15 ], inflammation [ 16 ], and circulating metabolites [ 17 ]. These biomarkers are also closely associated with the development of depression [ 18 ].…”

Natural products and dietary interventions on liver enzymes: an umbrella review and evidence map

“…Although chronic liver injury patients are usually asymptomatic, the liver enzymes appear generally significantly higher (7). In recent decades, several studies have indicated that liver enzyme disorders are associated with various diseases, such as chronic obstructive pulmonary disease (8), metabolic diseases (9), cardiovascular disease (10), and type 2 diabetes mellitus (T2DM) (11). Meanwhile, liver enzyme disorders are a significant predictive factors for increased patient mortality (12).…”