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Association Between Liver Enzyme and Risk of All-Cause Mortality: Use of Korean Genome and Epidemiology Study (KoGES) Data

간 효소(AST, ALT)와 전체원인사망 위험의 관련성: 한국인유전체역학조사 자료 활용

  • Lee, Tae-Yong (Dept. of Preventive Medicine, Chungnam National University School of Medicine) ;
  • Ryu, Hyo-Sun (Dept. of Medical Administration & Information, Daejeon Health Institute of Technology) ;
  • Park, Chang-Soo (Dept. of Nuclear Medicine, Chungnam National University Hospital)
  • 이태용 (충남대학교 의학전문대학원 예방의학교실) ;
  • 류효선 (대전보건대학교 의무행정정보학과) ;
  • 박창수 (충남대학교 병원 핵의학과)
  • Received : 2016.08.08
  • Accepted : 2016.11.10
  • Published : 2016.11.30

Abstract

This study was conducted to investigate the association of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) with all-cause mortality among populations. The data used were from a Korean Genome and Epidemiology Study (KoGES) based on health examinations and questionnaires. The subjects consisted of 10,110 persons aged 40 and over. Hazard ratio was analyzed using Cox's proportional hazard model. The hazard ratio of AST (${\geq}50.0\;IU/L$) was 2.198 (95% CI: 1.217-3.971) after being adjusted for age, sex, education, regular exercise, smoking, drinking, WHR, and TG. In conclusion, AST was an independent significant risk factor of all-cause mortality, and ALT showed a tendency to increase. Overall, these findings indicate that AST and ALT may be useful tools for predicting mortality.

간 효소(ALT와 AST)는 주로 간기능을 검사하는데 활용되지만, 간 효소와 심혈관질환 사망과의 관련성에 대한 연구들이 보고되고 있다. 본 연구는 간 효소와 전체사망원인의 관련성을 확인하고자 하였다. 연구자료는 2005년 8월과 2006년 12월에 한국농촌코호트(5개 지역) 연구에 참여한 40세 이상의 성인 10,110명의 건강검진 및 설문조사 자료와 2012년 12월 통계청의 사망자료를 병합하여 사용하였다. 분석방법은 5개 범주로 구분한 간 효소에 의한 사망위험비는 Cox의 비례위험모델을 이용하여 다른 위험요인들을 보정하여 분석하였다. 연구결과 지금까지 사망의 중요 위험요인들의 사망위험비는 65세 이상이 3.5배, 남자가 3.8배, 흡연 3.2배, WHR이 높을수록, 운동 안함 1.6배, 지질성분 및 PP2가 높을수록 높았으며, 이런 변수들을 보정한 상태에서 AST가 50 IU/L 이상일 때 사망위험비가 2.198배(95% CI: 1.217-3.971)였고, ALT도 증가하는 경향을 보였다. 이런 결과는 높은 값의 AST는 사망 위험을 높이는데 영향을 미치며, ALT도 사망을 예측하는데 유용한 도구가 될 수 있다는 것을 제시한다.

Keywords

References

  1. S. K. Kunutsor, T. A. Apekey, D. Seddoh, J Walley. Liver enzymes and risk of all-cause mortality in general populations: a systematic review and meta-analysis. International Journal of Epidemiology, vol. 43, pp. 187-201, 2014. DOI: http://dx.doi.org/10.1093/ije/dyt192
  2. A. L. C. Schneider, M. Lazo, C. E. Ndumele, J. S. Pankow, J. Coresh, J. M. Clark, E. Selvin. Liver enzyme, race, gender and diabetes risk: the Atherosclerosis Risk in Communities (ARIC) Study. Diabetic Medicine, vol. 30, pp. 926-933, 2013. DOI: http://dx.doi.org/10.1111/dme.12187
  3. D. S. Charles. Perioperative and perinatal death as measures for quality assurance. Quality in Health Care, vol. 2, pp.235-241, 1990. DOI: http://dx.doi.org/10.1093/intqhc/2.3-4.235
  4. World Health Organization. Global health risks. Mortality and burden of disease attributable to selected major risk. WHO Press, 2009.
  5. The Korean Society for Preventive Medicine, Preventive medicine and public health, 2nd edition. p. 194, Gyechuk Publishing Company, 2015.
  6. T. H. Lee, W. R. Kim, J.T. Benson, T.M. Therneau, L. J. Melton. Serum aminotransferase activity and mortality risk in a United States community. Hepatology, vol. 47, no. 3, pp. 880-887, 2008. DOI: http://dx.doi.org/10.1002/hep.22090
  7. The Korean Society for Preventive Medicine. The standardization of health statistics data collection and measurement. Gyechuk Munhyasa, pp. 128-132, 2000.
  8. The Korean Society of Hypertension. Hypertension treatment guideline 2013. p. 9, 2013.
  9. P. Jousilahti, E. Vartianinen, J. Tuomilehto, P. Puska. Sex, age, cardiovascular risk factors, and coronary heart disease. Circulation, vol. 99, pp. 1165-1172, 1999. DOI: http://dx.doi.org/10.1161/01.CIR.99.9.1165
  10. H. K. Kim, K. H. Choi, S. W. Lim, H. S. Rhee. Development of prediction model for prevalence of metabolic syndrome using data mining; Korea National Health and Nutrition Examination Study. Journal of Digital Convergence, vol. 14, no. 2, pp. 325-332. 2016. DOI: http://dx.doi.org/10.14400/JDC.2016.14.2.325
  11. J. Booth, L. Connelly, M. Lawrence, C. Chalmers, S. Joice, C. Becker, N. Dougall. Evidence of perceived psychosocial stress as a risk factor in adults: a meta-analysis. BMC Neurology, vol. 15, pp. 233-245, 2015. DOI: http://dx.doi.org/10.1186/s12883-015-0456-4
  12. T. L. Visscher, J. C. Seidell, A. Molarius, D. van der Kuip, A. Hofman, J. C. Witteman. A comparision of body mass indxes, waist-hip ratio and waist circumference as predictors of all-cause mortality among the elderly: The Rotterdam Study. International Journal of Obesity, vol. 25, pp. 1730-1735, 2001. DOI: http://dx.doi.org/10.1038/sj.ijo.0801787
  13. K. F. Adams, A. Scharzkin, T. B. Harris, V. Kipnis, T. Mouw, R. Ballard-Barbash, A. Hollenbeck, M. F. Leitzmann. Overweight, obesity, and mortality in large prospective cohort of persons 50 to 71 years old. the New England Journal of Medicine. vol. 355, no. 8, pp. 763-778, 2006. https://doi.org/10.1056/NEJMoa055643
  14. D. H. Nam. The measures of agreement between the classification standard of BMI and that of CDRS in women university students. Journal of Digital Convergence, vol. 14, no. 2, pp. 519-527. 2016. DOI: http://dx.doi.org/10.14400/JDC.2016.14.2.519
  15. Y. M. Kim, S. H. Kang. Changes and determinants affecting on geographic variations in health behavior, prevalence of hypertension and diabetes in Korean. Journal of Digital Convergence, vol. 13, no. 11, pp. 241-254. 2015. DOI: http://dx.doi.org/10.14400/JDC.2015.13.11.241
  16. N. H. Kim, H. J. Cho, Y. J. Kim, M. J. Cho, H. Y. Choi, C. R. Eun, J. H. Kim. K. M. Choi. Combined effect of high-normal blood pressure and low HDL cholesterol on mortality in an elderly Korean population: The South-West Seoul Study. American Journal of Hypertension, vol. 24, no. 8, pp. 918-923, 2011. DOI: http://dx.doi.org/10.1038/ajh.2011.78
  17. C. Anderson, L. van Gaal, I. D. Caterson, P. Weeke, W.P.T. James, W. Couthino, N. Finer, A. M. Sharma, A. P. Maggioni, C. Torp-Pedersen. Relationship between HbA1c levels and risk of cardiovascular adverse outcomes and all-cause mortality in overweight and obese cardiovascular high-risk women and men with type 2 diabetes. Diabetologia, vol. 55, pp. 2348-2355, 2012. DOI: http://dx.doi.org/10.1007/s00125-012-2584-3
  18. Statistics Korea. Statistical database: Cause of death, 2014.