Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

High Aspartate Aminotransferase/Alanine Aminotransferase Ratio is the Conventional Biochemical Biomarker that is Most Closely Associated with All-Cause Mortality in Older People

Version 1 : Received: 3 March 2022 / Approved: 4 March 2022 / Online: 4 March 2022 (11:17:44 CET)

A peer-reviewed article of this Preprint also exists.

Nakajima, K.; Yuno, M.; Tanaka, K.; Nakamura, T. High Aspartate Aminotransferase/Alanine Aminotransferase Ratio May Be Associated with All-Cause Mortality in the Elderly: A Retrospective Cohort Study Using Artificial Intelligence and Conventional Analysis. Healthcare 2022, 10, 674. Nakajima, K.; Yuno, M.; Tanaka, K.; Nakamura, T. High Aspartate Aminotransferase/Alanine Aminotransferase Ratio May Be Associated with All-Cause Mortality in the Elderly: A Retrospective Cohort Study Using Artificial Intelligence and Conventional Analysis. Healthcare 2022, 10, 674.

Journal reference: Healthcare 2022, 10, 674
DOI: 10.3390/healthcare10040674

Abstract

Low serum alanine aminotransferase activity and high aspartate aminotransferase (AST)/ALT ratio may be associated with high mortality in older people. We aimed to confirm this in an 8-year retrospective cohort study. Clinical data for 5,958 people aged 67–104 years were analyzed for their relationships with all-cause mortality using artificial intelligence (AI; Prediction One [Sony Network Communications Inc.]) and conventional statistical analysis (SAS Enterprise Guide [SAS Institute Inc.]). In total, 1,413 (23.7%) participants died during the study. Auto-AI analysis with five rounds of cross-validation showed that AST/ALT ratio was the third largest contributor to mortality, following age and sex. Serum albumin concentration and body mass index were the fourth and fifth largest contributors, and the individual serum ALT and AST activities were the seventh and tenth largest contributors. Conventional survival analysis showed that ALT, AST, and AST/ALT ratio as continuous variables were all associated with mortality (adjusted hazard ratios (95% confidence intervals): 0.98 (0.97–0.99), 1.02 (1.02–1.03), 1.46 (1.32–1.62), respectively; all p <0.0001). In conclusion, both AI and conventional analysis suggest that of the conventional biochemical markers, high AST/ALT ratio is most closely associated with all-cause mortality in older people.

Keywords

alanine aminotransferase; aspartate aminotransferase; AST/ALT ratio; mortality; artificial intelligence; older people

Subject

MEDICINE & PHARMACOLOGY, General Medical Research

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