Serum Transaminases and Older Adults: Distribution and Associations With All-Cause Mortality.

Autor:	Clayton-Chubb D; Department of Gastroenterology, Alfred Health, Melbourne, Victoria, Australia.; School of Translational Medicine, Monash University, Melbourne, Victoria, Australia., Majeed A; Department of Gastroenterology, Alfred Health, Melbourne, Victoria, Australia.; School of Translational Medicine, Monash University, Melbourne, Victoria, Australia., Roberts SK; Department of Gastroenterology, Alfred Health, Melbourne, Victoria, Australia.; School of Translational Medicine, Monash University, Melbourne, Victoria, Australia., Schneider HG; Department of Pathology, Alfred Health, Melbourne, Victoria, Australia.; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia., Commins I; Department of Gastroenterology, Alfred Health, Melbourne, Victoria, Australia.; Department of Gastroenterology, St Vincent's Hospital, Melbourne, Victoria, Australia., Fitzpatrick J; Department of Gastroenterology, Alfred Health, Melbourne, Victoria, Australia.; School of Translational Medicine, Monash University, Melbourne, Victoria, Australia., Woods RL; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia., Ryan J; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia., Hussain SM; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia., Tan N; Department of Gastroenterology, Alfred Health, Melbourne, Victoria, Australia.; School of Translational Medicine, Monash University, Melbourne, Victoria, Australia., Lubel JS; Department of Gastroenterology, Alfred Health, Melbourne, Victoria, Australia.; Department of Gastroenterology, Northern Health, Melbourne, Victoria, Australia., Tran C; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia., Hodge AD; Department of Gastroenterology, Eastern Health, Melbourne, Victoria, Australia.; School of Health and Biomedical Science, RMIT University, Melbourne, Victoria, Australia., McNeil JJ; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia., Kemp WW; Department of Gastroenterology, Alfred Health, Melbourne, Victoria, Australia.; School of Translational Medicine, Monash University, Melbourne, Victoria, Australia.
Jazyk:	angličtina
Zdroj:	The journals of gerontology. Series A, Biological sciences and medical sciences [J Gerontol A Biol Sci Med Sci] 2024 Nov 01; Vol. 79 (11).
DOI:	10.1093/gerona/glae203
Abstrakt:	Background: Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) are commonly ordered tests in general medical practice. However, their distribution and significance in older adults are understudied. As such, we aimed to evaluate sex-stratified distribution of both ALT and AST in older adults (≥70 years) and assess for associations with mortality. Methods: Post-hoc analysis of the ASPirin in Reducing Events in the Elderly (ASPREE) randomized, placebo-controlled trial of daily low-dose aspirin for initially relatively healthy older persons. Univariate analysis and multiple logistic regression were used to explore baseline characteristics. Cox regression and restricted cubic splines were used to examine links between transaminase levels and mortality. Results: Of the 11 853 participants with ALT and AST levels, 1 054 (8.9%) deaths were recorded over a median of 6.4 (interquartile range [IQR] 5.4-7.6) years. For ALT, the lowest quintiles for males and females were 6-15 and 5-13 U/L, respectively; for AST, the lowest quintiles were 8-18 and 7-17 U/L, respectively. On both univariate and models adjusted for covariates including age, body mass index, frailty, diabetes, and kidney disease, males and females in the lowest quintile of ALT had an increased hazard of mortality (aHR 1.51 [95% confidence interval {CI} 1.14-1.99] and aHR 1.39 [95% CI 1.03-1.88], respectively). For the lowest quintile of AST, only males were at increased risk (aHR 1.33 [95% CI 1.04-1.70]). Associations remained significant when removing outliers. Conclusions: Low ALT levels independently confer an increased hazard of mortality for older males and females; low AST only affected older male survival. Further evaluation of mechanisms would be worthwhile, and re-evaluating the lower limit of normal for ALT in older adults should be considered. (© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America.)
Databáze:	MEDLINE
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