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

Koshi Nakamura, Tomonori Okamura, Hideyuki Kanda, Takehito Hayakawa, Akira Okayama, Hirotsugu Ueshima, Shigeo Yamashita, Yoshinori Tominaga, Kazuaki Katsuyama, Fumihiko Kakuno, Machiko Kitanishi, Yukio Tobita, Kanehiro Okamura, Kiminobu Hatta, Takao Okada, Michiko Hatanaka

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

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 cost.

Original languageEnglish
Pages (from-to)15-20
Number of pages6
JournalJournal of Epidemiology
Volume16
Issue number1
DOIs
Publication statusPublished - 2005 Dec 20
Externally publishedYes

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antineoplaston A10
National Health Programs
Alanine Transaminase
Japan
Body Mass Index
Costs and Cost Analysis
Mortality
Serum
Independent Living
Insurance Benefits
Alanine

Keywords

  • Alanine transaminase
  • Body mass index
  • Health expenditure
  • Mortality

ASJC Scopus subject areas

  • Epidemiology

Cite this

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; Yamashita, Shigeo; Tominaga, Yoshinori; Katsuyama, Kazuaki; Kakuno, Fumihiko; Kitanishi, Machiko; Tobita, Yukio; Okamura, Kanehiro; Hatta, Kiminobu; Okada, Takao; Hatanaka, Michiko.

In: Journal of Epidemiology, Vol. 16, No. 1, 20.12.2005, p. 15-20.

Research output: Contribution to journalArticle

Nakamura, K, Okamura, T, Kanda, H, Hayakawa, T, Okayama, A, Ueshima, H, Yamashita, S, Tominaga, Y, Katsuyama, K, Kakuno, F, Kitanishi, M, Tobita, Y, Okamura, K, Hatta, K, Okada, T & Hatanaka, M 2005, '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', Journal of Epidemiology, vol. 16, no. 1, pp. 15-20. https://doi.org/10.2188/jea.16.15
Nakamura, Koshi ; Okamura, Tomonori ; Kanda, Hideyuki ; Hayakawa, Takehito ; Okayama, Akira ; Ueshima, Hirotsugu ; Yamashita, Shigeo ; Tominaga, Yoshinori ; Katsuyama, Kazuaki ; Kakuno, Fumihiko ; Kitanishi, Machiko ; Tobita, Yukio ; Okamura, Kanehiro ; Hatta, Kiminobu ; Okada, Takao ; Hatanaka, Michiko. / 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. In: Journal of Epidemiology. 2005 ; Vol. 16, No. 1. pp. 15-20.
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abstract = "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 cost.",
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AU - Okamura, Tomonori

AU - Kanda, Hideyuki

AU - Hayakawa, Takehito

AU - Okayama, Akira

AU - Ueshima, Hirotsugu

AU - Yamashita, Shigeo

AU - Tominaga, Yoshinori

AU - Katsuyama, Kazuaki

AU - Kakuno, Fumihiko

AU - Kitanishi, Machiko

AU - Tobita, Yukio

AU - Okamura, Kanehiro

AU - Hatta, Kiminobu

AU - Okada, Takao

AU - Hatanaka, Michiko

PY - 2005/12/20

Y1 - 2005/12/20

N2 - 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 cost.

AB - 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 cost.

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KW - Body mass index

KW - Health expenditure

KW - Mortality

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