BACKGROUND Stroke is a major cause of morbidity and mortality. Liver enzymes, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transpeptidase (GGT), are markers of liver diseases with potential cardiovascular implications. OBJECTIVE This study aimed to investigate the prospective association between liver enzymes and stroke risk. METHODS We analyzed data from 3,379 men and 4,007 women without cardiovascular disease and registered in the Suita Study; a Japanese population-based prospective cohort study. The hazard ratios (HRs) and 95% confidence intervals (95% CIs) of stroke risk were estimated per quintiles of ALT, AST, and GGT in men and women. RESULTS Within a median follow-up period of 16.7 years, 438 incident stroke events were diagnosed. In men, compared to the second quintiles, the fifth (highest) quintiles of liver enzymes showed increased stroke risks: HRs (95% CIs) = 2.07 (1.35, 3.18) in ALT, 1.66 (1.10, 2.53) in AST, and 1.76 (1.11, 2.81) in GGT. The associations did not change with cerebral infarction risk: HRs (95% CIs) = 2.09 (1.24, 3.50) in ALT, 1.84 (1.11, 3.06) in AST, and 1.74 (1.00, 3.04) in GGT, respectively. The lowest ALT, AST, and GGT quintiles tended to show increased stroke and cerebral infarction risks, yet these associations were statistically insignificant. No such associations were shown in women. CONCLUSION Elevated ALT, AST, and GGT levels were associated with increased stroke and cerebral infarction risks among Japanese men.

中文翻译：

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日本普通人群的肝酶和中风风险：一项前瞻性队列研究。

背景技术中风是发病和死亡的主要原因。肝酶、丙氨酸转氨酶 (ALT)、天冬氨酸转氨酶 (AST) 和 γ-谷氨酰转肽酶 (GGT) 是具有潜在心血管影响的肝病标志物。目的 本研究旨在调查肝酶与中风风险之间的前瞻性关联。方法 我们分析了 3,379 名没有心血管疾病的男性和 4,007 名女性的数据，并在吹田研究中进行了登记；一项基于日本人群的前瞻性队列研究。根据男性和女性 ALT、AST 和 GGT 的每五分位数估计中风风险的风险比 (HR) 和 95% 置信区间 (95% CI)。结果 在 16.7 年的中位随访期内，诊断出 438 起中风事件。在男性中，与第二个五分位数相比，肝酶的第五（最高）五分位数显示中风风险增加：ALT 的 HR（95% CI）= 2.07（1.35，3.18），AST 1.66（1.10，2.53），AST 1.76 GGT 中的 (1.11, 2.81)。这些关联不随脑梗死风险而变化：ALT 的 HR (95% CI) = 2.09 (1.24, 3.50)，AST 的 HR (95% CI) = 1.84 (1.11, 3.06)，GGT 的 HR (95% CI) = 1.74 (1.00, 3.04)。最低的 ALT、AST 和 GGT 五分位往往显示中风和脑梗塞风险增加，但这些关联在统计学上并不显着。在女性中没有显示出这种关联。结论 日本男性中 ALT、AST 和 GGT 水平升高与中风和脑梗塞风险增加相关。