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The association of liver enzymes with biomarkers of subclinical myocardial damage and structural heart disease.

TitleThe association of liver enzymes with biomarkers of subclinical myocardial damage and structural heart disease.
Publication TypeJournal Article
Year of Publication2015
AuthorsLazo M, Rubin J, Clark JM, Coresh JJ, Schneider ALC, Ndumele C, Hoogeveen RC, Ballantyne CM
Secondary AuthorsSelvin E
JournalJ Hepatol
Date Published2015 Apr
KeywordsAlanine Transaminase, Aspartate Aminotransferases, Asymptomatic Diseases, Biomarkers, Cross-Sectional Studies, Female, gamma-Glutamyltransferase, Heart Diseases, Humans, Male, Middle Aged, Natriuretic Peptide, Brain, Non-alcoholic Fatty Liver Disease, Peptide Fragments, Risk Factors, Statistics as Topic, Troponin T, United States

BACKGROUND & AIMS: Patients with non-alcoholic fatty liver disease (NAFLD) are thought to be at increased risk of cardiovascular morbidity and mortality. However, the relationships between NAFLD and subclinical myocardial injury or structural heart disease are unknown.

METHODS: We conducted a cross-sectional analysis of 8668 participants from the Atherosclerosis Risk in Communities (ARIC) Study, who showed no clinical evidence of cardiovascular disease. We used levels of liver enzymes (alanine aminotransferase [ALT], aspartate aminotransferase [AST] and gamma-glutamyl transpeptidase [GGT]), in the context of no history of elevated alcohol consumption as non-invasive surrogates of NAFLD. We used highly sensitive cardiac troponin T (hs-cTnT) and N-terminal pro-Brain natriuretic peptide (NT-proBNP) as biomarkers of myocardial damage and function.

RESULTS: In this population-based study (mean age 63 years, 60% women, 78% white), higher levels of ALT, AST, and GGT, even within the normal range, were significantly and independently associated with detectable (hs-cTnT >3 ng/L) and elevated (hs-cTnT ā©¾14 ng/L) concentrations of hs-cTnT. The adjusted odds ratios (95% confidence interval) for elevated liver enzymes (vs. normal levels) with elevated hs-cTnT were: 1.65 (1.28-2.14) for ALT, 1.90 (1.36-2.68) for AST, and 1.55 (1.13-2.12) for GGT. Furthermore, there was evidence for inverse associations of ALT and AST with NT-proBNP.

CONCLUSIONS: Our results suggest that elevated liver enzyme levels in the absence of elevated alcohol consumption may be associated with subclinical myocardial injury. The inverse association between NT-proBNP and both ALT and AST supports the recently described metabolic role of natriuretic peptides.

Alternate JournalJ Hepatol
PubMed ID25433159
PubMed Central IDPMC4373587
Grant ListUL1 TR001079 / TR / NCATS NIH HHS / United States
HHSN268201100005C / / PHS HHS / United States
R01 DK089174 / DK / NIDDK NIH HHS / United States
HHSN268201100009C / / PHS HHS / United States
HHSN268201100010C / / PHS HHS / United States
HHSN268201100008C / / PHS HHS / United States
HHSN268201100012C / / PHS HHS / United States
HHSN268201100007C / / PHS HHS / United States
HHSN268201100011C / / PHS HHS / United States
HHSN268201100006C / / PHS HHS / United States