Abstract
Alanine aminotransferase (ALT) is a marker of non-alcoholic fatty liver disease (NAFLD)
and predicts incident type 2 diabetes mellitus (DM2). Recently, ALT was shown to be
also associated with endothelial dysfunction and carotid atherosclerosis. We studied
the predictive value of ALT for all-cause mortality, incident cardiovascular disease
(CVD) and coronary heart disease (CHD) events in a population-based cohort of Caucasian
men and women aged 50–75 years, at baseline. The 10-year risk of all-cause mortality,
fatal and non-fatal CVD and CHD events in relation to ALT was assessed in 1439 subjects
participating in the Hoorn Study, using Cox survival analysis. Subjects with prevalent
CVD/CHD and missing data were excluded. As compared with the first tertile, the age-
and sex-adjusted hazard ratios (95% confidence intervals) for all-cause mortality,
CVD events and CHD events were 1.30 (0.92–1.83), 1.40 (1.09–1.81) and 2.04 (1.35–3.10),
respectively, for subjects in the upper tertile of ALT. After adjustment for components
of the metabolic syndrome and traditional risk factors, the association of ALT and
CHD events remained significant for subjects in the third relative to those in the
first tertile, with a hazard ratio of 1.88 (1.21–2.92) and 1.75 (1.12–2.73), respectively.
In conclusion, the predictive value of ALT for coronary events, seems independent
of traditional risk factors and the features of the metabolic syndrome in a population-based
cohort. Further studies should confirm these findings and elucidate the pathophysiological
mechanisms.
Keywords
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Article info
Publication history
Published online: May 09, 2006
Accepted:
April 4,
2006
Received in revised form:
March 29,
2006
Received:
October 28,
2005
Footnotes
☆Part of the results have been presented in an oral presentation at 41st Scientific Meeting of the European Associations for the Study of Diabetes (EASD); 15 September 2005; Athens, Greece.
Identification
Copyright
© 2006 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
