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The independent effects of cigarette smoking, alcohol consumption, and serum aspartate aminotransferase on the alanine aminotransferase ratio in korean men for the risk for esophageal cancer

 Heejin Kimm  ;  Sangwon Kim  ;  Sun Ha Jee 
 YONSEI MEDICAL JOURNAL, Vol.51(3) : 310-317, 2010 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Alanine Transaminase/blood* ; Alcohol Drinking/adverse effects* ; Asian Continental Ancestry Group ; Aspartate Aminotransferases/blood* ; Esophageal Neoplasms/enzymology* ; Esophageal Neoplasms/epidemiology* ; Esophageal Neoplasms/etiology ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Risk Factors ; Smoking/adverse effects*
Alcohol ; smoking ; alanine transaminase ; aspartate aminotransferases ; esophageal neoplasms
PURPOSE: The goal of this study is to assess the interactions among alcohol consumption, cigarette smoking, and aspartate aminotransferase (AST) / alanine aminotransferase (ALT) ratios on esophageal cancer. MATERIALS AND METHODS: Alcohol and the risk of incidence and death from esophageal cancer were examined in a 14-year prospective cohort study of 782,632 Korean men, 30 to 93 years of age, who received health insurance from the National Health Insurance Corporation and had a medical evaluation from 1992 to 1995. RESULTS: Smoking, alcohol intake, and AST/ALT ratios were associated with the increased risk of esophageal cancer in a dose-dependent manner independent of each other. Smoking was associated with an increased risk of incidence [Hazard ratio (HR) = 2.2, 95% CI = 1.8 to 2.5] and mortality (HR = 2.5, 2.0 to 3.1). Combined HR of incidence for alcohol consumption (> 25 g/day) and smoking was 4.5 (3.8-5.5); for alcohol (> 25 g/day) and the AST/ALT ratio (>or= 2.0), it was 5.8 (4.6-7.2); for smoking and the AST/ALT ratio (>or= 2.0), it was 6.3 (5.1-7.5). Similar results were seen for mortality from esophageal cancer. Subjects who drank >or= 25 g/day with an AST/ALT ratio >or= 2 had a higher risk of esophageal cancer incidence (HR = 6.5, 4.8 to 8.7) compared with those who drank >or= 25 g/day with an AST/ALT ratio < 2 (HR = 2.2, 1.9 to 2.6). CONCLUSION: Alcohol, smoking, and the AST/ALT ratio are independently associated with increased risk of esophageal cancer but did not interact synergistically. The combination of the AST/ALT ratio with a questionnaire for alcohol consumption may increase the effectiveness for determining the risk of esophageal cancer.
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4. Graduate School of Public Health (보건대학원) > Graduate School of Public Health (보건대학원) > 1. Journal Papers
Yonsei Authors
Kimm, Heejin(김희진) ORCID logo https://orcid.org/0000-0003-4526-0570
Jee, Sun Ha(지선하) ORCID logo https://orcid.org/0000-0001-9519-3068
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