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Validation of Dynamic Aspartate‐to–Alanine Aminotransferase Ratio for Predicting Liver Disease Mortality
The dynamic aspartate‐to–alanine aminotransferase ratio (dAAR) was developed recently to predict the risk of incident chronic liver disease among the Nordic adult population; however, the dAAR has not been externally validated in other ethnic cohorts. Therefore, we aimed to examine the predictive ab...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8948584/ https://www.ncbi.nlm.nih.gov/pubmed/34713990 http://dx.doi.org/10.1002/hep4.1844 |
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author | Song, In‐Ae Jang, Eun Sun Oh, Tak Kyu |
author_facet | Song, In‐Ae Jang, Eun Sun Oh, Tak Kyu |
author_sort | Song, In‐Ae |
collection | PubMed |
description | The dynamic aspartate‐to–alanine aminotransferase ratio (dAAR) was developed recently to predict the risk of incident chronic liver disease among the Nordic adult population; however, the dAAR has not been externally validated in other ethnic cohorts. Therefore, we aimed to examine the predictive ability of dAAR for liver disease mortality in the South Korean adult population. As a population‐based cohort study, we used the National Health Screening Cohort database, which included adult individuals who underwent standardized medical examinations between 2002 and 2003 in South Korea. The primary endpoint was liver disease mortality, defined as death due to liver disease. Liver disease mortality was evaluated between 2004 and 2015 (12 years). Analysis of data from 512,749 adults showed that 4,052 (0.8%) individuals died due to liver disease. On receiver operating characteristic (ROC) analyses, the area under curve for alanine aminotransferase (ALT), aspartate‐to‐ALT ratio (AAR), and dAAR for liver disease mortality were 0.74, 0.55, and 0.81, respectively. The cutoff point of dAAR was determined to be 0.72 on ROC analysis, using the Youden index method. On competing risk analysis using the Fine and Gray model, the dAAR > 0.72 group demonstrated a 4.43‐fold higher rate of liver disease mortality (subdistribution hazard ratio: 4.43, 95% confidence interval: 4.11, 4.77; P < 0.001) after adjustment for covariates. Conclusion: The performance of dAAR in predicting liver disease mortality was better than that of AAR or ALT in South Korea. Our study suggests that dAAR scores can potentially be used for screening and predicting liver disease mortality among the general Korean population. |
format | Online Article Text |
id | pubmed-8948584 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-89485842022-03-29 Validation of Dynamic Aspartate‐to–Alanine Aminotransferase Ratio for Predicting Liver Disease Mortality Song, In‐Ae Jang, Eun Sun Oh, Tak Kyu Hepatol Commun Original Articles The dynamic aspartate‐to–alanine aminotransferase ratio (dAAR) was developed recently to predict the risk of incident chronic liver disease among the Nordic adult population; however, the dAAR has not been externally validated in other ethnic cohorts. Therefore, we aimed to examine the predictive ability of dAAR for liver disease mortality in the South Korean adult population. As a population‐based cohort study, we used the National Health Screening Cohort database, which included adult individuals who underwent standardized medical examinations between 2002 and 2003 in South Korea. The primary endpoint was liver disease mortality, defined as death due to liver disease. Liver disease mortality was evaluated between 2004 and 2015 (12 years). Analysis of data from 512,749 adults showed that 4,052 (0.8%) individuals died due to liver disease. On receiver operating characteristic (ROC) analyses, the area under curve for alanine aminotransferase (ALT), aspartate‐to‐ALT ratio (AAR), and dAAR for liver disease mortality were 0.74, 0.55, and 0.81, respectively. The cutoff point of dAAR was determined to be 0.72 on ROC analysis, using the Youden index method. On competing risk analysis using the Fine and Gray model, the dAAR > 0.72 group demonstrated a 4.43‐fold higher rate of liver disease mortality (subdistribution hazard ratio: 4.43, 95% confidence interval: 4.11, 4.77; P < 0.001) after adjustment for covariates. Conclusion: The performance of dAAR in predicting liver disease mortality was better than that of AAR or ALT in South Korea. Our study suggests that dAAR scores can potentially be used for screening and predicting liver disease mortality among the general Korean population. John Wiley and Sons Inc. 2021-10-29 /pmc/articles/PMC8948584/ /pubmed/34713990 http://dx.doi.org/10.1002/hep4.1844 Text en © 2021 The Authors. Hepatology Communications published by Wiley Periodicals LLC on behalf of American Association for the Study of Liver Diseases. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Articles Song, In‐Ae Jang, Eun Sun Oh, Tak Kyu Validation of Dynamic Aspartate‐to–Alanine Aminotransferase Ratio for Predicting Liver Disease Mortality |
title | Validation of Dynamic Aspartate‐to–Alanine Aminotransferase Ratio for Predicting Liver Disease Mortality |
title_full | Validation of Dynamic Aspartate‐to–Alanine Aminotransferase Ratio for Predicting Liver Disease Mortality |
title_fullStr | Validation of Dynamic Aspartate‐to–Alanine Aminotransferase Ratio for Predicting Liver Disease Mortality |
title_full_unstemmed | Validation of Dynamic Aspartate‐to–Alanine Aminotransferase Ratio for Predicting Liver Disease Mortality |
title_short | Validation of Dynamic Aspartate‐to–Alanine Aminotransferase Ratio for Predicting Liver Disease Mortality |
title_sort | validation of dynamic aspartate‐to–alanine aminotransferase ratio for predicting liver disease mortality |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8948584/ https://www.ncbi.nlm.nih.gov/pubmed/34713990 http://dx.doi.org/10.1002/hep4.1844 |
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