Alanine Aminotransferase and 20-Year Risk of Major Chronic Diseases and Death in a Healthy Cohort Aged 30 to 49 Years

Figures & data

Table 1 Baseline Characteristics of 671 Healthy Participants Ages 30–49 from the Ebeltoft Health Promotion Project in Denmark, 1991–1992

ALT	Low (N = 29)	Medium-Low  (N = 488)	Medium-High (N = 132)	High (N = 22)	Total (N = 671)
Sex, (%)
Male	1 (3.4)	237 (48.6)	76 (57.6)	14 (63.6)	328 (48.9)
Female	28 (96.6)	251 (51.4)	56 (42.4)	8 (36.4)	343 (51.1)
Age, median (IQR)	39.0 (35.0–43.0)	41.0 (36.0–45.0)	39.5 (34.5–45.0)	42.5 (39.0–46.0)	40.0 (36.0–45.0)
Weight^a, median (IQR)	61.0 (57.0–66.5)	70.0 (60.0–80.0)	82.0 (70.0–90.0)	73.0 (60.0–85.0)	71.5 (61.0–82.0)
BMI^b, median (IQR)	21.5 (20.7–24.2)	23.3 (21.4–25.7)	25.9 (24.0–28.7)	24.4 (21.7–27.8)	23.8 (21.6–26.5)
Smoking Status, (%)
Never	11 (37.9)	177 (36.3)	51 (38.6)	3 (13.6)	242 (36.1)
Former	5 (17.2)	61 (12.5)	17 (12.9)	5 (22.7)	88 (13.1)
Current	13 (44.8)	250 (51.2)	64 (48.5)	14 (63.6)	341 (50.8)
Weekly alcohol consumption^c, median (IQR)	3 (2–7)	6 (2–13)	7 (2–20)	19 (10–28)	6 (2–14)
Marital Status^d, (%)
Married or living together	24 (82.8)	420 (86.2)	112 (84.9)	17 (77.3)	573 (85.5)
Living alone	5 (17.2)	67 (13.8)	20 (15.2)	5 (22.7)	97 (14.5)

Notes: ^aMeasured in kg; Data was missing for 13 participants (Medium-Low: 10, Medium-High: 3) ^bData was missing for 22 participants (Medium-Low: 16, Medium-High: 6) ^cMeasured in units of 12g alcohol/unit; data was missing for 12 participants (Low: 1, Medium-Low: 8, Medium-High: 3) ^dData was missing for 1 participant (Medium-Low: 1).

Abbreviations: IQR, interquartile range (ie 25th–75th percentile); BMI, body mass index (kg/m²).

Table 2 Cumulative Incidence by ALT Category and Outcome Event

	Cumulative Incidence (%) (95% Confidence Interval)
	Low (N = 29)	Medium-Low (N = 488)	Medium-High (N = 132)	High (N = 22)
Liver Disease
10-year risk	0	0.6 (0.2–1.7)	0.8 (0.1–3.8)	4.5 (0.3–18.9)
20-year risk	0	1.0 (0.4–2.3)	0.8 (0.1–3.8)	13.6 (3.4–30.9)
Overall Cancer
10-year risk	10.3 (2.6–24.3)	3.1 (1.8–4.9)	0.8 (0.1–3.8)	4.5 (0.3–18.9)
20-year risk	17.2 (6.3–32.7)	8.4 (6.2–11.1)	6.1 (2.8–11.0)	18.2 (5.7–36.3)
Ischemic Heart Disease
10-year risk	3.4 (0.3–14.9)	3.7 (2.3–5.6)	0.8 (0.1–3.8)	0
20-year risk	3.4 (0.3–14.9)	9.3 (6.9–12.0)	6.8 (3.3–12.0)	9.1 (1.6–25.1)
Diabetes
10-year risk	0	0.4 (0.1–1.4)	4.5 (1.9–9.1)	4.5 (0.3–18.9)
20-year risk	3.4 (0.3–14.9)	1.0 (0.4–2.3)	12.1 (7.3–18.3)	9.1 (1.6–25.1)
No Event
10-year risk	86 (67–95)	92 (89–94)	92 (85–95)	86 (63–95)
20-year risk	76 (56–88)	79 (75–82)	72 (63–79)	50 (28–68)
Any Event
10-year risk	14 (5.4–33)	8.2 (6.1–11)	8.3 (4.7–15)	14 (4.6–37)
20-year risk	24 (12–44)	21 (18–25)	28 (21–37)	50 (32–72)

Notes: Note that the risk of “any event” is the sum of the risks of a diagnosis of liver disease, overall cancer, ischemic heart disease, or diabetes, as well as ‘death without liver disease, cancer, ischemic heart disease, or diabetes’ (before rounding). It is also 100% minus the “risk” of no event.

Figure 1 Cumulative all-cause mortality by ALT concentration.

Figure 2 Hazard ratios of liver disease, overall cancer, ischemic heart disease, diabetes, and all-cause mortality adjusted for sex, age, and smoking status. (A) Liver Disease (B) Overall cancer (C) Ischemic Heart Disease (D) Diabetes (E) All-Cause Mortality.