Cargando…
The Value of Combining Serum Alanine Aminotransferase Levels and Body Mass Index to Predict Mortality and Medical Costs: a 10-year Follow-up Study of National Health Insurance in Shiga, Japan
BACKGROUND: Evidence suggests that the predictive value of serum alanine aminotransferase (ALT) levels for prognosis, measured by indices such as all-cause mortality and medical costs, may be modified by body mass index (BMI). However, the relationship between serum ALT and BMI has not been satisfac...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Japan Epidemiological Association
2005
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7560549/ https://www.ncbi.nlm.nih.gov/pubmed/16369104 http://dx.doi.org/10.2188/jea.16.15 |
_version_ | 1783595112186511360 |
---|---|
author | Nakamura, Koshi Okamura, Tomonori Kanda, Hideyuki Hayakawa, Takehito Okayama, Akira Ueshima, Hirotsugu |
author_facet | Nakamura, Koshi Okamura, Tomonori Kanda, Hideyuki Hayakawa, Takehito Okayama, Akira Ueshima, Hirotsugu |
author_sort | Nakamura, Koshi |
collection | PubMed |
description | BACKGROUND: Evidence suggests that the predictive value of serum alanine aminotransferase (ALT) levels for prognosis, measured by indices such as all-cause mortality and medical costs, may be modified by body mass index (BMI). However, the relationship between serum ALT and BMI has not been satisfactorily elucidated. METHODS: Four thousand, five hundred and twenty-four community dwelling Japanese National Health Insurance beneficiaries, 40-69 years old, were classified into five categories according to their serum ALT levels (IU/L) (ALT<20, 20≤ALT<30, 30≤ALT<40, 40≤ALT<50 and 50≤ALT) and followed for 10 years. Hazard ratios for all-cause mortality, with reference to the lowest serum ALT category, and medical costs per person were evaluated for each serum ALT category after analyzing interactions between serum ALT levels and BMI for all-cause mortality and for medical costs. RESULTS: A significant interaction between serum ALT levels and BMI was observed. In participants below the median BMI, positive, graded relationships were identified between serum ALT levels and all-cause mortality as well as between serum ALT levels and personal medical costs. The multivariate-adjusted hazard ratio in the “50≤ALT” category showed an approximately 8-fold increase. However, in the participants at or above the median BMI, no significant relationships between serum ALT levels and all-cause mortality or personal medical costs were identified. CONCLUSIONS: In these Japanese participants, the predictive value of serum ALT levels for prognosis was more evident if BMI was taken into account. A combination of high serum ALT levels and below median BMI was associated with excess mortality and medical costs. |
format | Online Article Text |
id | pubmed-7560549 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2005 |
publisher | Japan Epidemiological Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-75605492020-10-30 The Value of Combining Serum Alanine Aminotransferase Levels and Body Mass Index to Predict Mortality and Medical Costs: a 10-year Follow-up Study of National Health Insurance in Shiga, Japan Nakamura, Koshi Okamura, Tomonori Kanda, Hideyuki Hayakawa, Takehito Okayama, Akira Ueshima, Hirotsugu J Epidemiol Original Article BACKGROUND: Evidence suggests that the predictive value of serum alanine aminotransferase (ALT) levels for prognosis, measured by indices such as all-cause mortality and medical costs, may be modified by body mass index (BMI). However, the relationship between serum ALT and BMI has not been satisfactorily elucidated. METHODS: Four thousand, five hundred and twenty-four community dwelling Japanese National Health Insurance beneficiaries, 40-69 years old, were classified into five categories according to their serum ALT levels (IU/L) (ALT<20, 20≤ALT<30, 30≤ALT<40, 40≤ALT<50 and 50≤ALT) and followed for 10 years. Hazard ratios for all-cause mortality, with reference to the lowest serum ALT category, and medical costs per person were evaluated for each serum ALT category after analyzing interactions between serum ALT levels and BMI for all-cause mortality and for medical costs. RESULTS: A significant interaction between serum ALT levels and BMI was observed. In participants below the median BMI, positive, graded relationships were identified between serum ALT levels and all-cause mortality as well as between serum ALT levels and personal medical costs. The multivariate-adjusted hazard ratio in the “50≤ALT” category showed an approximately 8-fold increase. However, in the participants at or above the median BMI, no significant relationships between serum ALT levels and all-cause mortality or personal medical costs were identified. CONCLUSIONS: In these Japanese participants, the predictive value of serum ALT levels for prognosis was more evident if BMI was taken into account. A combination of high serum ALT levels and below median BMI was associated with excess mortality and medical costs. Japan Epidemiological Association 2005-12-20 /pmc/articles/PMC7560549/ /pubmed/16369104 http://dx.doi.org/10.2188/jea.16.15 Text en © 2006 Japan Epidemiological Association. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Original Article Nakamura, Koshi Okamura, Tomonori Kanda, Hideyuki Hayakawa, Takehito Okayama, Akira Ueshima, Hirotsugu The Value of Combining Serum Alanine Aminotransferase Levels and Body Mass Index to Predict Mortality and Medical Costs: a 10-year Follow-up Study of National Health Insurance in Shiga, Japan |
title | The Value of Combining Serum Alanine Aminotransferase Levels and Body Mass Index to Predict Mortality and Medical Costs: a 10-year Follow-up Study of National Health Insurance in Shiga, Japan |
title_full | The Value of Combining Serum Alanine Aminotransferase Levels and Body Mass Index to Predict Mortality and Medical Costs: a 10-year Follow-up Study of National Health Insurance in Shiga, Japan |
title_fullStr | The Value of Combining Serum Alanine Aminotransferase Levels and Body Mass Index to Predict Mortality and Medical Costs: a 10-year Follow-up Study of National Health Insurance in Shiga, Japan |
title_full_unstemmed | The Value of Combining Serum Alanine Aminotransferase Levels and Body Mass Index to Predict Mortality and Medical Costs: a 10-year Follow-up Study of National Health Insurance in Shiga, Japan |
title_short | The Value of Combining Serum Alanine Aminotransferase Levels and Body Mass Index to Predict Mortality and Medical Costs: a 10-year Follow-up Study of National Health Insurance in Shiga, Japan |
title_sort | value of combining serum alanine aminotransferase levels and body mass index to predict mortality and medical costs: a 10-year follow-up study of national health insurance in shiga, japan |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7560549/ https://www.ncbi.nlm.nih.gov/pubmed/16369104 http://dx.doi.org/10.2188/jea.16.15 |
work_keys_str_mv | AT nakamurakoshi thevalueofcombiningserumalanineaminotransferaselevelsandbodymassindextopredictmortalityandmedicalcostsa10yearfollowupstudyofnationalhealthinsuranceinshigajapan AT okamuratomonori thevalueofcombiningserumalanineaminotransferaselevelsandbodymassindextopredictmortalityandmedicalcostsa10yearfollowupstudyofnationalhealthinsuranceinshigajapan AT kandahideyuki thevalueofcombiningserumalanineaminotransferaselevelsandbodymassindextopredictmortalityandmedicalcostsa10yearfollowupstudyofnationalhealthinsuranceinshigajapan AT hayakawatakehito thevalueofcombiningserumalanineaminotransferaselevelsandbodymassindextopredictmortalityandmedicalcostsa10yearfollowupstudyofnationalhealthinsuranceinshigajapan AT okayamaakira thevalueofcombiningserumalanineaminotransferaselevelsandbodymassindextopredictmortalityandmedicalcostsa10yearfollowupstudyofnationalhealthinsuranceinshigajapan AT ueshimahirotsugu thevalueofcombiningserumalanineaminotransferaselevelsandbodymassindextopredictmortalityandmedicalcostsa10yearfollowupstudyofnationalhealthinsuranceinshigajapan AT nakamurakoshi valueofcombiningserumalanineaminotransferaselevelsandbodymassindextopredictmortalityandmedicalcostsa10yearfollowupstudyofnationalhealthinsuranceinshigajapan AT okamuratomonori valueofcombiningserumalanineaminotransferaselevelsandbodymassindextopredictmortalityandmedicalcostsa10yearfollowupstudyofnationalhealthinsuranceinshigajapan AT kandahideyuki valueofcombiningserumalanineaminotransferaselevelsandbodymassindextopredictmortalityandmedicalcostsa10yearfollowupstudyofnationalhealthinsuranceinshigajapan AT hayakawatakehito valueofcombiningserumalanineaminotransferaselevelsandbodymassindextopredictmortalityandmedicalcostsa10yearfollowupstudyofnationalhealthinsuranceinshigajapan AT okayamaakira valueofcombiningserumalanineaminotransferaselevelsandbodymassindextopredictmortalityandmedicalcostsa10yearfollowupstudyofnationalhealthinsuranceinshigajapan AT ueshimahirotsugu valueofcombiningserumalanineaminotransferaselevelsandbodymassindextopredictmortalityandmedicalcostsa10yearfollowupstudyofnationalhealthinsuranceinshigajapan |