Association Between Liver Enzyme and Risk of All-Cause Mortality: Use of Korean Genome and Epidemiology Study (KoGES) Data

간 효소(AST, ALT)와 전체원인사망 위험의 관련성: 한국인유전체역학조사 자료 활용

  • Lee, Tae-Yong (Dept. of Preventive Medicine, Chungnam National University School of Medicine) ;
  • Ryu, Hyo-Sun (Dept. of Medical Administration & Information, Daejeon Health Institute of Technology) ;
  • Park, Chang-Soo (Dept. of Nuclear Medicine, Chungnam National University Hospital)
  • 이태용 (충남대학교 의학전문대학원 예방의학교실) ;
  • 류효선 (대전보건대학교 의무행정정보학과) ;
  • 박창수 (충남대학교 병원 핵의학과)
  • Received : 2016.08.08
  • Accepted : 2016.11.10
  • Published : 2016.11.30


This study was conducted to investigate the association of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) with all-cause mortality among populations. The data used were from a Korean Genome and Epidemiology Study (KoGES) based on health examinations and questionnaires. The subjects consisted of 10,110 persons aged 40 and over. Hazard ratio was analyzed using Cox's proportional hazard model. The hazard ratio of AST (${\geq}50.0\;IU/L$) was 2.198 (95% CI: 1.217-3.971) after being adjusted for age, sex, education, regular exercise, smoking, drinking, WHR, and TG. In conclusion, AST was an independent significant risk factor of all-cause mortality, and ALT showed a tendency to increase. Overall, these findings indicate that AST and ALT may be useful tools for predicting mortality.


KoGES;AST;ALT;All-cause mortality;Hazard ratio


Supported by : 충남대학교


  1. S. K. Kunutsor, T. A. Apekey, D. Seddoh, J Walley. Liver enzymes and risk of all-cause mortality in general populations: a systematic review and meta-analysis. International Journal of Epidemiology, vol. 43, pp. 187-201, 2014. DOI:
  2. A. L. C. Schneider, M. Lazo, C. E. Ndumele, J. S. Pankow, J. Coresh, J. M. Clark, E. Selvin. Liver enzyme, race, gender and diabetes risk: the Atherosclerosis Risk in Communities (ARIC) Study. Diabetic Medicine, vol. 30, pp. 926-933, 2013. DOI:
  3. D. S. Charles. Perioperative and perinatal death as measures for quality assurance. Quality in Health Care, vol. 2, pp.235-241, 1990. DOI:
  4. World Health Organization. Global health risks. Mortality and burden of disease attributable to selected major risk. WHO Press, 2009.
  5. The Korean Society for Preventive Medicine, Preventive medicine and public health, 2nd edition. p. 194, Gyechuk Publishing Company, 2015.
  6. T. H. Lee, W. R. Kim, J.T. Benson, T.M. Therneau, L. J. Melton. Serum aminotransferase activity and mortality risk in a United States community. Hepatology, vol. 47, no. 3, pp. 880-887, 2008. DOI:
  7. The Korean Society for Preventive Medicine. The standardization of health statistics data collection and measurement. Gyechuk Munhyasa, pp. 128-132, 2000.
  8. The Korean Society of Hypertension. Hypertension treatment guideline 2013. p. 9, 2013.
  9. P. Jousilahti, E. Vartianinen, J. Tuomilehto, P. Puska. Sex, age, cardiovascular risk factors, and coronary heart disease. Circulation, vol. 99, pp. 1165-1172, 1999. DOI:
  10. H. K. Kim, K. H. Choi, S. W. Lim, H. S. Rhee. Development of prediction model for prevalence of metabolic syndrome using data mining; Korea National Health and Nutrition Examination Study. Journal of Digital Convergence, vol. 14, no. 2, pp. 325-332. 2016. DOI:
  11. J. Booth, L. Connelly, M. Lawrence, C. Chalmers, S. Joice, C. Becker, N. Dougall. Evidence of perceived psychosocial stress as a risk factor in adults: a meta-analysis. BMC Neurology, vol. 15, pp. 233-245, 2015. DOI:
  12. T. L. Visscher, J. C. Seidell, A. Molarius, D. van der Kuip, A. Hofman, J. C. Witteman. A comparision of body mass indxes, waist-hip ratio and waist circumference as predictors of all-cause mortality among the elderly: The Rotterdam Study. International Journal of Obesity, vol. 25, pp. 1730-1735, 2001. DOI:
  13. K. F. Adams, A. Scharzkin, T. B. Harris, V. Kipnis, T. Mouw, R. Ballard-Barbash, A. Hollenbeck, M. F. Leitzmann. Overweight, obesity, and mortality in large prospective cohort of persons 50 to 71 years old. the New England Journal of Medicine. vol. 355, no. 8, pp. 763-778, 2006.
  14. D. H. Nam. The measures of agreement between the classification standard of BMI and that of CDRS in women university students. Journal of Digital Convergence, vol. 14, no. 2, pp. 519-527. 2016. DOI:
  15. Y. M. Kim, S. H. Kang. Changes and determinants affecting on geographic variations in health behavior, prevalence of hypertension and diabetes in Korean. Journal of Digital Convergence, vol. 13, no. 11, pp. 241-254. 2015. DOI:
  16. N. H. Kim, H. J. Cho, Y. J. Kim, M. J. Cho, H. Y. Choi, C. R. Eun, J. H. Kim. K. M. Choi. Combined effect of high-normal blood pressure and low HDL cholesterol on mortality in an elderly Korean population: The South-West Seoul Study. American Journal of Hypertension, vol. 24, no. 8, pp. 918-923, 2011. DOI:
  17. C. Anderson, L. van Gaal, I. D. Caterson, P. Weeke, W.P.T. James, W. Couthino, N. Finer, A. M. Sharma, A. P. Maggioni, C. Torp-Pedersen. Relationship between HbA1c levels and risk of cardiovascular adverse outcomes and all-cause mortality in overweight and obese cardiovascular high-risk women and men with type 2 diabetes. Diabetologia, vol. 55, pp. 2348-2355, 2012. DOI:
  18. Statistics Korea. Statistical database: Cause of death, 2014.