Associations Of Serum Liver Enzymes Levels And Their Changes With Incident Cardiovascular Disease

Objective: Systematic inflammation caused by impaired liver function might lead to various diseases,but associations of serum liver enzymes levels and their changes with incident cardiovascular disease(CVD)are unclear.Methods: After excluding individuals with CVD,cancer,severely abnormal electrocardiogram(ECG)and lost to follow-up,we included 31751 individuals who were first enrolled in the Dongfeng-tongji cohort at baseline survey from September 2008 to June 2010 and the first follow-up from April to October 2013 to evaluate the associations between baseline liver enzymes and incident CVD;and we included 15935 individuals who completed both surveys and free of CVD,cancer or severely abnormal ECG to evaluate the associations between changes of liver enzymes with incident CVD.We measured serum aspartate aminotransferase(AST),alanine aminotransferase(ALT)and alkaline phosphatase(ALP)with Architect Ci8200 integrated system.We used cox proportional hazard model to estimate the hazard ratios(HRs)and 95% confidence intervals(CIs)of incident CVD in relation to liver enzymes levels and their changes.Results: During(5.8±2.5)years of follow-up,compared with moderate aminotransferase group(19~27 U/L for AST and 16~26 U/L for ALT)at baseline,the adjusted HRs(95% CIs)of low AST(<19 U/L)and high ALT(>26 U/L)were 1.10(1.02-1.18)and 1.09(1.01-1.16)for incident CVD,respectively.Furthermore,during(3.4±0.8)years of follow-up,compared with group showing moderate and stable AST(baseline AST 19~27 U/L,AST change-5~5 U/L),individuals with high AST at baseline and elevated AST(baseline AST >27 U/L,AST change >5 U/L)had a significant higher risk of CVD,and the adjusted HR(95% CI)was 1.45(1.07-1.96).Conclusions: We found individuals with low or high aminotransferase level had a higher risk of CVD,and individuals with high AST at baseline and elevated AST had a significantly higher risk of CVD.