This Article Full Text Full Text (PDF) All Versions of this Article: 36/8/1642    most recent 01.STR.0000173404.37692.9bv1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Kim, H. C. Articles by Suh, I. Search for Related Content PubMed PubMed Citation Articles by Kim, H. C. Articles by Suh, I. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Hazardous Substances DB (L)-ASPARTIC ACID GLUCOSE Related Collections Epidemiology Intracerebral Hemorrhage Primary and Secondary Stroke Prevention Risk Factors for Stroke

(Stroke. 2005;36:1642.)
© 2005 American Heart Association, Inc.

Original Contributions

Elevated Serum Aminotransferase Level as a Predictor of Intracerebral Hemorrhage

Korea Medical Insurance Corporation Study

Hyeon Chang Kim, MD, PhD; Dae Ryong Kang, PhD; Chung Mo Nam, PhD; Nam Wook Hur, PhD; Jee Seon Shim, MPH; Sun Ha Jee, PhD Il Suh, MD, PhD

From the Department of Preventive Medicine, Yonsei College of Medicine (H.C.K., D.R.K., C.M.N., N.W.H., J.S.S., I.S.) and the Graduate School of Public Health, Yonsei University (S.H.J.), Seoul, Korea.

Correspondence to Il Suh, MD, PhD, Department of Preventive Medicine, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, Republic of Korea. E-mail isuh{at}yumc.yonsei.ac.kr

Background and Purpose— Serum aminotransferase levels are known to be associated with cardiovascular risk factors, but the relation with stroke incidence is not well known. We investigated the relation between serum aminotransferase levels and the incidence of stroke.

Methods— We measured serum aspartate and alanine aminotransferase levels and traditional cardiovascular risk factors in 108 464 Korean men, aged 35 to 59 years, in 1990 and 1992. Serum aminotransferase levels were classified into 3 categories (<35, 35 to 69, and 70 IU/L). The outcomes were hospital admissions and deaths from stroke subtypes (ischemic stroke, intracerebral hemorrhage [ICH], and subarachnoid hemorrhage [SAH]) from 1993 to 2002.

Results— During the 10 years, 1728 ischemic, 1051 hemorrhagic (718 ICH and 222 SAH), and 243 unspecified stroke events occurred. After adjustment for age and other traditional risk factors and according to Cox proportional-hazards models, serum aminotransferase level had an independent positive associations with ICH. However, ischemic stroke and SAH were not associated with aminotransferase levels. Compared with the level <35 IU/L, the adjusted relative risks (95% confidence interval) of ICH for an aspartate aminotransferase level of 35 to 69 and 70 IU/L were 1.49 (1.21 to 1.83) and 4.21 (3.06 to 5.77), respectively. The corresponding risks for alanine aminotransferase were 1.34 (1.09 to 1.65) and 2.89 (2.09 to 4.01), respectively. These associations were consistent regardless of the level of obesity, blood pressure, fasting glucose, alcohol intake, and follow-up length.

Conclusions— These findings suggest that an elevated aminotransferase level is a predictor of ICH. The biologic significance of aminotransferase level for the development of ICH merits further study.

Key Words: alanine aminotransferase • aspartate aminotransferase • epidemiology • intracerebral hemorrhage • risk factors