Association of the Aspartate Aminotransferase to Alanine Aminotransferase Ratio with BNP Level and Cardiovascular Mortality in the General Population: The Yamagata Study 10-Year Follow-Up

Yokoyama, Masahiro; Watanabe, Tetsu; Otaki, Yoichiro; Takahashi, Hiroki; Arimoto, Takanori; Shishido, Tetsuro; Miyamoto, Takuya; Konta, Tsuneo; Shibata, Yoko; Daimon, Makoto; Ueno, Yoshiyuki; Kato, Takeshi; Kayama, Takamasa; Kubota, Isao

doi:10.1155/2016/4857917

Cited by 80 publications

(97 citation statements)

References 29 publications

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“…Yokoyama et al [26] recently concluded that an increased AST/ALT ratio positively correlates with NT-proBNP levels, yet their study was not specific for HFrEF patients.…”

Section: Discussionmentioning

confidence: 95%

AST/ALT ratio predicts the functional severity of chronic heart failure with reduced left ventricular ejection fraction

et al. 2020

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Objective: Despite previous research that focused on liver transaminases as predictors of cardiovascular disease, there has been limited research evaluating the predictive value of AST/ALT ratio in patients with heart failure. We aimed to investigate AST/ALT ratio as an indicator of the functional severity in chronic heart failure with reduced left ventricular ejection fraction. Results:Overall, 105 patients previously diagnosed with HFrEF from Buraidah-Al Qassim province, Saudi Arabia were included in this retrospective cross-sectional study. Data on study variables, including demographic data, left ventricular ejection fraction, NYHA class, and AST/ALT ratio, were collected from patients' records. The patients were divided into two groups, namely group-1 (AST/ALT ratio < 1) and group-2 (AST/ALT ratio ≥ 1), to identify any differences in their cardiac function profiles. NYHA class and NT-proBNP were higher and LVEF was lower in group-2 than in group-1. We found a mild significant correlation between AST/ALT ratio and APRI, FIB-4 score, NYHA-class, and LVEF (r = 0.2, 0.25, 0.26, and − 0.24, respectively; P < 0.05). Multivariate linear regression analysis model and ROC curve showed that AST/ALT ratio could independently predict HFrEF functional severity with a best cut-off value of 0.9, sensitivity of 43.6%, and specificity of 81.4%.

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“…Yokoyama et al [26] recently concluded that an increased AST/ALT ratio positively correlates with NT-proBNP levels, yet their study was not specific for HFrEF patients.…”

Section: Discussionmentioning

confidence: 95%

AST/ALT ratio predicts the functional severity of chronic heart failure with reduced left ventricular ejection fraction

et al. 2020

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“…Cox proportional hazard regression models were used to investigate the prognostic value of TG/HDL-C on diabetes risk, and adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated to evaluate the risk of diabetes. According to the recommendation of the STROBE statement [15], we simultaneously showed the results from unadjusted, minimally adjusted analyses and those from fully adjusted analyses. Whether the covariances were adjusted determined by the following principle: when added to this model, changed the matched hazard ratio by at least 10% [16].…”

Section: Discussionmentioning

confidence: 99%

Association of Triglyceride to high-density lipoprotein cholesterol ratio and incident of diabetes mellitus: a secondary retrospective analysis based on a Chinese cohort study

Chen

et al. 2020

Lipids Health Dis

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Background: Previous studies have revealed that triglyceride to high-density lipoprotein cholesterol ratio (TG/HDL-C) is one of major risk factors of insulin resistance and diabetes. However, study on the association between TG/ HDL-C and diabetes mellitus (DM) risk is limited, especially in Chinese people. This study was undertaken to investigate the relationship between TG/HDL-C and incident of diabetes in a large cohort in Chinese population. Methods: The present study was a retrospective cohort study. A total of 114,787 adults from Rich Healthcare Group in China, which includes all medical records for participants who received a health check from 2010 to 2016. The target independent variable and the dependent variable were triglyceride to high-density lipoprotein cholesterol ratio measured at baseline and incident of diabetes mellitus appeared during follow-up respectively. Covariates involved in this study included age, gender, body mass index, diastolic blood pressure, systolic blood pressure, fasting plasma glucose, total cholesterol, low density lipoprotein cholesterol, serum creatinine, smoking and drinking status and family history of diabetes. Cox proportional-hazards regression was used to investigate the association of TG/HDL-C and diabetes. Generalized additive models was used to identify non-linear relationships. Additionally, we also performed a subgroup analysis. It was stated that the data had been uploaded to the DATADRYAD website.(Continued on next page) Result: After adjusting age, gender, body mass index, systolic blood pressure, diastolic blood pressure, fasting blood glucose, total cholesterol, low density lipoprotein cholesterol, serum creatinine, smoking and drinking status and family history of diabetes, result showed TG/HDL-C was positively associated with incident of diabetes mellitus (HR = 1.159, 95%CI (1.104, 1.215)). A non-linear relationship was detected between TG/HDL-C and incident of diabetes, which had an inflection point of TG/HDL-C was 1.186. The effect sizes and the confidence intervals on the left and right sides of the inflection point were 1.718(1.433,2.060) and 1.049(0.981,1.120), respectively. Subgroup analysis showed, the stronger association can be found in the population with fasting plasma glucose (FPG) < 6.1 mmol/L (P for interaction< 0.0001; HR = 1.296 with FPG < 6.1 mmol/L vs HR = 1.051 with FPG ≥ 6.1 mmol/L).The same trend was also seen in the population with body mass index (BMI)(≥18.5, < 24 kg/m 2 ) (P for interaction = 0.010,HR = 1.324) and family history without diabetes(P for interaction = 0.025, HR = 1.170).Conclusion: TG/HDL-C is positively associated with diabetes risk. The relationship between TG/HDL-C and incident of diabetes is also non-linear. TG/HDL-C was strong positively related to incident of diabetes when TG/HDL-C is less than 1.186.

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“…Aminotransferase, including AST and ALT, is a well-known marker for liver injury. AST is in both the liver and myocardial tissue, but ALT is only in the liver [8]. The elevation of the AST/ALT ratio is due to induction by alcohol consumption and cardio-hepatic interaction [16,24].…”

Section: Discussionmentioning

confidence: 99%

“…Aminotransferase is a well-known marker for liver injury and is composed of alanine aminotransferase (ALT) and aspartate aminotransferase (AST). ALT is only located in the liver, but AST is in both the liver and myocardial tissue [8]. A more significant increase in AST characterizes the elevation of aminotransferase in CVD compared with ALT, which presented an increased AST/ALT ratio in patients with CVD [9,10].…”

Section: Introductionmentioning

confidence: 99%

“…A previous study showed that a history of CVD rate was higher in subjects with a high AST/ALT ratio than in those with a normal AST/ALT ratio, which suggested that an elevated AST/ALT ratio may reflect cardiac load and damage and the presence of latent CVD [11,12]. A previous study with a 10-year follow-up reported that the increased AST/ALT ratio, as a new nontraditional risk for CVD, was an independent predictor of CVD mortality in the general population who participated in a community-based health check-up, [8]. Another study from the United Kingdom showed that elevated AST/ALT ratio is significantly associated with an increased risk of developing CVD in men with no history of CVD at baseline [13].…”

Section: Introductionmentioning

confidence: 99%

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Association between Aminotransferase/alanine Aminotransferase Ratio and Cardiovascular Disease mortality in Patients on Peritoneal Dialysis: A Multi-center Retrospective Study

Feng

Wen

Peng

et al. 2020

Preprint

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Objectives: Elevated aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio is an independent risk factor for cardiovascular disease (CVD) among the general population. However, an association between AST/ALT ratio and CVD mortality in patients on peritoneal dialysis (PD) has received little attention.Methods: A total of 2224 incident PD patients from multi-centers were enrolled from November 1, 2005, to June 30, 2017, in this retrospective cohort study. The primary endpoint was CVD mortality. Eligible patients were divided into high and normal groups according to the AST/ALT ratio cut-off for CVD mortality with the receiver operating characteristic (ROC) curve. The associations between the AST/ALT ratio and CVD mortality were evaluated by the Cox regression model.Results: Of eligible 1579 patients with a mean age of 49.3±14.6 years, 55.4% of patients were male, 18.1% of patients had diabetes, and 64.2% of patients had hypertension. The prevalence of a high AST/ALT ratio was 76.6% in the cohort population. During a follow-up period with 4659.6 patient-years, 316 patients died, of which 193 (61.1%) deaths were caused by CVD episodes. The incidence of CVD mortality in the high group was significantly higher than that in the normal group (13.1% versus 9.2%, P=0.024). Cumulative CVD mortality rates were significantly different between the two groups by Kaplan-Meier analysis [hazards ratio (HR)=1.50, 95% confidence index (CI) 1.09-2.07, P=0.014]. After adjusting for confounding factors, a higher AST/ALT ratio was independently associated with an increased risk of CVD mortality compared with their counterparts (HR=1.43, 95%CI 1.08-2.41, P=0.002). Conclusions: PD patients with high baseline AST/ALT ratio levels may be at a significant risk of CVD mortality.

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Association of the Aspartate Aminotransferase to Alanine Aminotransferase Ratio with BNP Level and Cardiovascular Mortality in the General Population: The Yamagata Study 10-Year Follow-Up

Cited by 80 publications

References 29 publications

AST/ALT ratio predicts the functional severity of chronic heart failure with reduced left ventricular ejection fraction

AST/ALT ratio predicts the functional severity of chronic heart failure with reduced left ventricular ejection fraction

Association of Triglyceride to high-density lipoprotein cholesterol ratio and incident of diabetes mellitus: a secondary retrospective analysis based on a Chinese cohort study

Association between Aminotransferase/alanine Aminotransferase Ratio and Cardiovascular Disease mortality in Patients on Peritoneal Dialysis: A Multi-center Retrospective Study

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