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Liver Enzyme Levels Predict Cardiac Risk in Metabolic Syndrome

Liver enzyme elevations are associated with high concentrations of C-reactive protein.

At the Rambam Medical Center in Haifa, Dr. Arthur Kerner and colleagues measured alanine aminotransferase, alkaline phosphatase, and C-reactive protein levels in 1740 middle-aged individuals being evaluated for cardiac risk factors.

The researchers report that patients with elevated levels of either of the two liver enzymes, defined as levels in the upper quartile of the study population, also had higher C-reactive protein levels compared to subjects with normal liver enzyme levels.

The adjusted odds for a high-risk C-reactive protein level, that is, greater than 3 mg/L were 1.5 for patients with elevated alanine aminotransferase and 2.1 for patients with elevated alkaline phosphatase.

The authors comment that their results "show a direct association between elevated liver function tests…and serum C-reactive protein concentrations." This association, they add, was independent of the presence of metabolic abnormalities, level of physical activity, smoking habits, and other factors known to influence C-reactive protein levels.

"Given that C-reactive protein levels provide additional prognostic information regarding subsequent cardiovascular events in people with the metabolic syndrome, the results of this study suggest that…minor liver abnormalities are also relevant in the context of cardiovascular risk," they conclude.
Arterioscler Thromb Vasc Biol 2005;25:193-197.