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Title: Low alanine aminotransferase levels and higher number of cardiovascular events in people with Type 2 diabetes: analysis of the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) study.
Authors: Williams, K H;Sullivan, D R;Veillard, A S;O'Brien, R;George, J;Jenkins, A J;Young, S;Ehnholm, C;Duffield, A;Twigg, S M;Keech, A C
Affiliation: Sydney Medical School, University of Sydney, Sydney, NSW, Australia
Royal Prince Alfred Hospital, Sydney, NSW, Australia
National Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia
Austin Health, Heidelberg, Victoria, Australia
Storr Liver Unit, Westmead Millennium Institute, Westmead Hospital, Sydney, NSW, Australia
Diabetes Clinic, Northshore Hospital, Auckland, New Zealand
Biomedicum Helsinki, Helsinki, Finland
Clinical Research Centre, Royal Hobart Hospital, Hobart, Tasmania, Australia
Issue Date: Mar-2016
EDate: 2015-12-07
Citation: Diabetic medicine 2016; 33(3): 356-64
Abstract: To determine whether alanine aminotransferase or gamma-glutamyltransferase levels, as markers of liver health and non-alcoholic fatty liver disease, might predict cardiovascular events in people with Type 2 diabetes. Data from the Fenofibrate Intervention and Event Lowering in Diabetes study were analysed to examine the relationship between liver enzymes and incident cardiovascular events (non-fatal myocardial infarction, stroke, coronary and other cardiovascular death, coronary or carotid revascularization) over 5 years. Alanine aminotransferase measure had a linear inverse relationship with the first cardiovascular event occurring in participants during the study period. After adjustment, for every 1 sd higher baseline alanine aminotransferase measure (13.2 U/l), the risk of a cardiovascular event was 7% lower (95% CI 4-13; P = 0.02). Participants with alanine aminotransferase levels below and above the reference range 8-41 U/l for women and 9-59 U/l for men, had hazard ratios for a cardiovascular event of 1.86 (95% CI 1.12-3.09) and 0.65 (95% CI 0.49-0.87), respectively (P = 0.001). No relationship was found for gamma-glutamyltransferase. The data may indicate that in people with Type 2 diabetes, which is associated with higher alanine aminotransferase levels because of prevalent non-alcoholic fatty liver disease, a low alanine aminotransferase level is a marker of hepatic or systemic frailty rather than health.
DOI: 10.1111/dme.12972
PubMed URL: 26433207
Type: Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Appears in Collections:Journal articles

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