Liver enzymes: potential cardiovascular risk markers?

Area of Science:

• Biochemistry
• Cardiology
• Endocrinology

Background:

• Cross-sectional studies show a link between elevated liver enzymes (ALT, GGT) and metabolic syndrome (MetS) or diabetes mellitus (DM).
• Prospective studies indicate that raised liver enzyme activity predicts future MetS, DM, cardiovascular (CV) events, and mortality.
• This association appears independent of alcohol intake, suggesting other contributing factors.

Purpose of the Study:

• To explore the relationship between elevated liver enzymes and metabolic syndrome, diabetes, and cardiovascular risk.
• To investigate potential underlying mechanisms contributing to increased CV risk, such as inflammation and oxidative stress.
• To emphasize the importance of gamma-glutamyltransferase (GGT) in relation to atherosclerotic plaque.

Main Methods:

• Review of cross-sectional and prospective studies examining liver enzyme activity.
• Analysis of associations between liver enzymes (ALT, GGT) and MetS, DM, CV events, and mortality.
• Exploration of potential mediating factors like non-alcoholic fatty liver disease (NAFLD), insulin resistance, inflammation, and oxidative stress.

Main Results:

• Consistent associations found between elevated ALT and GGT and MetS/DM.
• Liver enzyme elevation independently predicted future MetS, DM, and CV outcomes.
• The link between GGT and atherosclerotic plaque was identified as particularly significant.

Conclusions:

• Elevated liver enzymes are significant predictors of metabolic and cardiovascular diseases.
• Mechanisms beyond NAFLD and insulin resistance, including inflammation and oxidative stress, likely contribute to this risk.
• GGT's association with atherosclerotic plaque warrants further investigation in cardiovascular risk assessment.