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Alanine transaminase has opposite associations with death from diabetes and ischemic heart disease in NHANES III.

Abstract：

PURPOSE:Diabetes increases the risk of ischemic heart disease (IHD). Stringent control of diabetes does not reliably reduce cardiovascular events. Some global regions, such as East Asia, have low mortality rates from IHD and high rates of diabetes. We hypothesized that some aspects of liver function might underlie this paradox. METHODS:We used multivariable proportional hazards regression in 16,865 adults from the National Health and Nutrition Examination Survey (NHANES) III (1988-1994) followed until December 31, 2006, to assess the adjusted associations of gender-specific tertiles of alanine transaminase (ALT), as a marker of hepatocellular damage, and bilirubin (BIL), as a marker of other aspects of liver function, with death from diabetes (n = 132), IHD related to diabetes (n = 153), and IHD unrelated to diabetes (n = 921). RESULTS:ALT was positively associated with death from diabetes (hazard ratio [HR], 2.17; 95% confidence interval [CI], 1.19-3.98 for high compared with low ALT tertile) and IHD related to diabetes (HR, 2.14; 95% CI, 1.07-4.31), but negatively associated with IHD unrelated to diabetes (HR, 0.76; 95% CI, 0.58-0.98) adjusted for age, gender, education, race/ethnicity, smoking, and alcohol use. BIL had no such associations. CONCLUSIONS:ALT may be a marker of an underlying etiology relating to the paradoxical associations of diabetes and IHD at a population level.

journal_name

Ann Epidemiol

journal_title

Annals of epidemiology

authors

Schooling CM,Kelvin EA,Jones HE

doi

10.1016/j.annepidem.2012.08.003

subject

Has Abstract

pub_date

2012-11-01 00:00:00

pages

789-98

issue

11

eissn

1047-2797

issn

1873-2585

pii

S1047-2797(12)00337-7

journal_volume

22

pub_type

杂志文章

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