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Elevated hepatic enzymes and incidence of venous thromboembolism: a prospective study.

TitleElevated hepatic enzymes and incidence of venous thromboembolism: a prospective study.
Publication TypeJournal Article
Year of Publication2014
AuthorsFolsom AR, Lutsey PL, Roetker NS, Rosamond WD, Lazo M, Heckbert SR, Basu S, Cushman M
Secondary AuthorsSelvin E
JournalAnn Epidemiol
Volume24
Issue11
Pagination817-821.e2
Date Published2014 Nov
ISSN1873-2585
KeywordsAge Factors, Alanine Transaminase, Alcohol Drinking, Aspartate Aminotransferases, Body Mass Index, Diabetes Mellitus, Female, gamma-Glutamyltransferase, Humans, Incidence, Male, Middle Aged, Prospective Studies, Risk Factors, Venous Thromboembolism
Abstract

PURPOSE: Approximately 10% of the general population has elevated blood concentrations of hepatic enzymes, which are linked to increased coagulation markers. We tested whether elevated hepatic enzymes are associated with increased risk of venous thromboembolism (VTE).

METHODS: We followed 12,604 adults with measurements of alanine transaminase, aspartate aminotransferase (AST), and gamma-glutamyl transpeptidase (GGT) prospectively for VTE occurrence.

RESULTS: AST and GGT above the laboratory normal values were associated over two decades of follow-up with increased risk of total (n = 532) and provoked VTE (n = 332), but with not unprovoked VTE (n = 200). In a model adjusted for age, race, sex, hormone replacement, alcohol intake, diabetes, body mass index, estimated glomerular filtration rate, and C-reactive protein, the hazard ratios (HR) (95% confidence interval) for high versus normal AST were 1.46 (1.00-2.11) for total VTE and 1.83 (1.21-2.79) for provoked VTE. For high GGT, the HR were 1.34 (1.06-1.69) for total VTE and 1.43 (1.07-1.91) for provoked VTE. When follow-up was limited to the first 10 years, associations were even stronger (HR ≈ 1.7 for total VTE).

CONCLUSIONS: Elevated concentrations of two hepatic enzymes (AST and GGT) in this general middle-aged population are associated with a modestly increased risk of VTE.

DOI10.1016/j.annepidem.2014.08.004
Alternate JournalAnn Epidemiol
PubMed ID25277506
PubMed Central IDPMC4254154
Grant ListHHSN268201100012C / HL / NHLBI NIH HHS / United States
HHSN268201100010C / HL / NHLBI NIH HHS / United States
HHSN268201100008C / HL / NHLBI NIH HHS / United States
R01 DK089174 / DK / NIDDK NIH HHS / United States
R01 HL059367 / HL / NHLBI NIH HHS / United States
HHSN268201100007C / HL / NHLBI NIH HHS / United States
HHSN268201100011C / HL / NHLBI NIH HHS / United States
HHSN268201100006C / HL / NHLBI NIH HHS / United States
HHSN268201100009C / HL / NHLBI NIH HHS / United States
HHSN268201100005C / HL / NHLBI NIH HHS / United States