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Joint Effect of Hepatic Steatosis and Alanine Aminotransferase Within the Normal Range on Incident Ischemic Heart Disease: A Prospective Study in Koreans

 Dong-Hyuk Jung  ;  Yong Jae Lee  ;  Byoungjin Park 
 CLINICAL INTERVENTIONS IN AGING, Vol.16 : 513-523, 2021-03 
Journal Title
Issue Date
alanine aminotransferase ; extrahepatic complication ; hepatic steatosis ; ischemic heart disease ; prospective cohort study
Purpose: Hepatic steatosis has been associated with some cardiovascular risks. Increased alanine aminotransferase (ALT) was suggested to be linked to endothelial dysfunction. We prospectively investigated the joint effect of hepatic steatosis and elevated ALT within the normal range on incident ischemic heart disease (IHD) risk as an extrahepatic complication. Patients and methods: We assessed 16,541 participants without diabetes using data from a health risk assessment study (HERAS) and Korean Health Insurance Review and Assessment (HIRA) data. We defined elevated ALT within the normal range as 30-40 IU/L in men and 23-40 IU/L in women, according to previous Korean epidemiological data. We prospectively assessed hazard ratios (HRs) with 95% confidence intervals (CIs) for IHD using multivariate Cox proportional hazards regression models over a 50-month period after the baseline survey. Results: During the follow-up period, 368 (2.2%) participants developed IHD. Compared to the group with no hepatic steatosis and controlled ALT, the HRs for IHD were 1.68 (95% CI, 1.16-2.42) in the group with hepatic steatosis and elevated ALT after adjusting for confounding variables. Conclusion: Hepatic steatosis and elevated ALT levels within the normal range may jointly affect the development of IHD among nondiabetic adults. This indicates that lifestyle advice and vascular health management should be recommended among individuals with hepatic steatosis and elevated ALT, even if it falls within the normal range.
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1. College of Medicine (의과대학) > Dept. of Family Medicine (가정의학교실) > 1. Journal Papers
Yonsei Authors
Park, Byoungjin(박병진) ORCID logo https://orcid.org/0000-0003-1733-5301
Lee, Yong Jae(이용제) ORCID logo https://orcid.org/0000-0002-6697-476X
Jung, Dong Hyuk(정동혁) ORCID logo https://orcid.org/0000-0002-3411-0676
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