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dc.contributor.authorWilliams, K H-
dc.contributor.authorSullivan, D R-
dc.contributor.authorVeillard, A S-
dc.contributor.authorO'Brien, R-
dc.contributor.authorGeorge, J-
dc.contributor.authorJenkins, A J-
dc.contributor.authorYoung, S-
dc.contributor.authorEhnholm, C-
dc.contributor.authorDuffield, A-
dc.contributor.authorTwigg, S M-
dc.contributor.authorKeech, A C-
dc.identifier.citationDiabetic medicine 2016; 33(3): 356-64-
dc.description.abstractTo 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.-
dc.titleLow 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.-
dc.typeJournal Article-
dc.identifier.journaltitleDiabetic medicine : a journal of the British Diabetic Association-
dc.identifier.affiliationSydney Medical School, University of Sydney, Sydney, NSW, Australia-
dc.identifier.affiliationRoyal Prince Alfred Hospital, Sydney, NSW, Australia-
dc.identifier.affiliationNational Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia-
dc.identifier.affiliationAustin Health, Heidelberg, Victoria, Australia-
dc.identifier.affiliationStorr Liver Unit, Westmead Millennium Institute, Westmead Hospital, Sydney, NSW, Australia-
dc.identifier.affiliationDiabetes Clinic, Northshore Hospital, Auckland, New Zealand-
dc.identifier.affiliationBiomedicum Helsinki, Helsinki, Finland-
dc.identifier.affiliationClinical Research Centre, Royal Hobart Hospital, Hobart, Tasmania, Australia-
dc.type.austinJournal Article-
dc.type.austinMulticenter Study-
dc.type.austinRandomized Controlled Trial-
dc.type.austinResearch Support, Non-U.S. Gov't-'Brien, Richard C
item.fulltextNo Fulltext-
item.openairetypeJournal Article- of Melbourne Clinical School-
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