Liver enzyme variability and risk of heart disease and mortality: A nationwide population‐based study

Cho, Eun Ju; Han, Kyungdo; Lee, Seung–Pyo; Shin, Dong Wook; Yu, Su Jong

doi:10.1111/liv.14432

Cited by 27 publications

(22 citation statements)

References 29 publications

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“…In a recent nationwide population-based study in Korea, higher variability in AST, ALT, and γ-glutamyltransferase levels was associated with a higher risk for all-cause mortality, myocardial infarction, atrial fibrillation, and congestive heart failure. In addition, these findings were consistent regardless of baseline characteristics including alco-hol consumption, BMI, and degree of fatty liver [22]. However, to our best knowledge, our current study is the first report to determine the association between visit-to-visit liver enzyme variability and diabetes risk independent of traditional risk factors of diabetes and mean levels.…”

Section: Discussionsupporting

confidence: 76%

Increased Visit-to-Visit Liver Enzyme Variability Is Associated with Incident Diabetes: A Community-Based 12-Year Prospective Cohort Study

et al. 2021

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Background: Fatty liver and/or increased liver enzyme values have been reported to be associated with incident diabetes. We sought to determine whether increased visit-to-visit liver enzyme variability is associated with incident diabetes.Methods: Study participants were recruited from the Korean Genome and Epidemiologic Study (KoGES). A total of 4,151 people aged 40 to 69 years was recruited and tested every 2 years for up to 12 years. Visit-to-visit aspartate aminotransferase (AST) and alanine aminotransferase (ALT) variability was evaluated in first the 6-year period through the use of various variability measurements: standard deviation (SD), average successive variability, coefficient of variation (CV), and variation independent of mean (VIM). Oral glucose tolerance test was performed at every visit.Results: During the 6-year follow‐up appointments, 13.0% (538/4,151) of people developed incident diabetes. Visit-to-visit AST variability was associated with an increased risk of diabetes independent of conventional risk factors for diabetes (hazard ratio per 1-SD increment [95% confidence interval]: 1.06 [1.00 to 1.11], 1.12 [1.04 to 1.21], and 1.13 [1.04 to 1.22] for SD, CV, and VIM, respectively; all P<0.05); however, no such associations were observed in the visit-to-visit ALT variability. According to alcohol consumption status, both AST and ALT variability were independent predictors for incident diabetes in subjects with heavy alcohol consumption; however, neither AST nor ALT variability was associated with diabetes risk in subjects who did not drink alcohol heavily.Conclusion: Visit-to-visit liver enzyme variability is an independent predictor of incident diabetes. Such association was more evident in those who consumed significant amounts of alcohol.

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Section: Discussionsupporting

confidence: 76%

Increased Visit-to-Visit Liver Enzyme Variability Is Associated with Incident Diabetes: A Community-Based 12-Year Prospective Cohort Study

et al. 2021

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“…Even though TBil is not an independent risk factor for valvular AF recurrence in the multivariate analysis, we found that the AUC area increased after adding TBil variable to the model(model1 AUC 0.720 versus model3 AUC 0.679) which indicating that there may becomes more statistically significant differences between TBil and valvular AF recurrence in larger cohorts. In addition, liver injury parameters (ALT, AST, GGT), mainly GGT, has been considered as a significantly risk factor of cardiovascular diseases, including myocardial infarction, stroke and atrial fibrillation(AF) 32,[35][36][37] . Although GGT level is reasonable to assume related to the elevated occurrence of AF in previous studies, we found no statistically difference in AF recurrence.…”

Section: Discussionmentioning

confidence: 99%

A novel predictive model of recurrence after surgical ablation of valvular atrial fibrillation

Wang

Tang

Adili

et al. 2021

Preprint

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Background: Radiofrequency ablation(RFA) has emerged as a common approach to treatment of atrial fibrillation(AF) coupled with valve surgery. However, risk factors were rarely reported on recurrence after RFA of valvular atrial fibrillation . Methods: Retrospective study of a single-center database was performed in patients underwent valvular surgery combined with radiofrequency ablation. Follow-up was conducted from 3 months to 1 year after procedure. AF recurrence was defined as any episode of atrial arrhythmia lasting more than 30 seconds. Risk factors were analysis using Logistic regression and a predictive model was established. Results: 3-month follow-up was completed in 319 patients, 195 patients (61.1%) had AF recurrence. During the 1-year follow-up, 74 /166 patients(44.6%) had AF recurrence. Compared with sinus rhythm maintenance group, overweight(p=0.022), high BMI(p=0.024), large preoperative LAD(p<0.001), small MI area(p=0.019), large MI diameter(p<0.001) and other liver function parameter like low ALT level(p=0.023), high total bilirubin(p=0.013) and direct bilirubin level(p=0.033) were significantly correlated with AF recurrence after RF. In multivariate analysis, BMI(OR 1.12, 95% CI 1.04-1.21, p=0.003), LAD(OR 1.49, 95% CI 1.09-2.07, p=0.015), MI area(OR 0.41, 95% CI 0.18-0.85, p=0.023), MI diameter(OR 2.45, 95% CI 1.16-5.34, p=0.021), ALT(OR 0.98, 95% CI 0.97-0.99, p=0.002) and eGFR(OR 1.01, 95% CI 1.09-1.02, p=0.042) were significantly independent risk predictors of AF early recurrence. A predictive model was created with AUC of 0.720. Conclusions: BMI、LAD、MI area、MI diameter、ALT and eGFR were risk predictors of AF early recurrence. We established a predictive model and it devote to preoperative clinical health management of individual with valvular AF.

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“…And besides liver function, AST was also used to evaluate myocaridium damage. Some reports indicated that higher visit-to-visit variability of liver enzymes was an independent predictor of all-cause mortality and cardiovascular events [30,31]. From the analysis mentioned above, acute cardiac injury would appear in about 59% patients in nonsurvivors' group compared to 1% in survivors', and usually happened 15 days after admission with acute elevation of hsTnI [7].…”

Section: Discussionmentioning

confidence: 99%

Admission biochemical test associated with the prognosis of COVID-19: a multi-centered retrospective cohort study

Long¹,

Zhou²,

Wang³

et al. 2020

Preprint

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Objectives: Since December 2019, a outbreak of Corona Virus Disease-2019(COVID-19) started in Wuhan, China. Now we comprehended much more about the troublesome disease from studies than the beginning. But more details between admission laboratory test and prognosis of COVID-19 were still confusing. So we focused on the admission biochemical test, and tried to verify their influence to the prognosis of COVID-19.Method: 522 patients from 4 hospitals were enrolled in this retrospective cohort study. We collected demographic information, comorbidities and laboratory biochemical indicators, then compared them between survivors’ and nonsurvivors’ group. Logistic regression methods were used to explore the risk factors associated with in-hospital death. Linear regression and receiver operating characteristic curve(ROC-curve) was applied to assess the efficiency of risk factors and regression model.Results:Age of nonsurvivors’ group(68.9) was older than survivors group(50.0). Diabetes(68.7%) was the most common comorbidity in the nonsurvivors’ group. In univariate regression analysis, most biochemical tests were related to the mortality except lipid metabolic results. Age, fasting blood glucose and blood urea nitrogen(BUN) were with a p-value less than 0.001 in multivariate regression model.Conclusion:Age, BUN and fasting blood glucose were risk factors associated with the prognosis of COVID-19 related pneumonia.Authors Qi Long, Chen-liang Zhou, Ye-ming Wang, Bin Song, Xiao-bin Cheng, Qiu-fen Dong, and Liu-lin Wang contributed equally to this work.

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Liver enzyme variability and risk of heart disease and mortality: A nationwide population‐based study

Cited by 27 publications

References 29 publications

Increased Visit-to-Visit Liver Enzyme Variability Is Associated with Incident Diabetes: A Community-Based 12-Year Prospective Cohort Study

Increased Visit-to-Visit Liver Enzyme Variability Is Associated with Incident Diabetes: A Community-Based 12-Year Prospective Cohort Study

A novel predictive model of recurrence after surgical ablation of valvular atrial fibrillation

Admission biochemical test associated with the prognosis of COVID-19: a multi-centered retrospective cohort study

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