Lower alanine aminotransferase levels are associated with increased all-cause and cardiovascular mortality in nonalcoholic fatty liver patients

Table 6 Association of different models, all-cause, cardiovascular disease, cancer-related and others-related mortality among nonalcoholic fatty liver disease patients

Mortality outcome	No. of death, n (%)	Unadjusted		Age-adjusted		Multivariate-adjusted
		HR (95%CI)	P value	HR (95%CI)	P value	HR (95%CI)	P value
All-cause
Model 1	1055 (41.9)	1		1		1
Model 2	248 (31.2)	0.68 (0.59-0.78)	< 0.001	0.89 (0.77-1.02)	0.1	0.87 (0.74-1.01)	0.067
Model 3	271 (53.7)	1.45 (1.26-1.65)	< 0.001	1.11 (0.97-1.27)	0.139	0.98 (0.85-1.12)	0.727
Model 4	121 (35.5)	0.82 (0.68-0.99)	0.037	0.91 (0.75-1.10)	0.312	0.81 (0.66-0.99)	0.042
Cardiovascular disease
Model 1	309 (12.3)	1		1		1
Model 2	68 (8.6)	0.64 (0.49-0.83)	< 0.001	0.86 (0.66-1.12)	0.254	0.89 (0.65-1.20)	0.437
Model 3	72 (14.3)	1.30 (1.01-1.68)	0.045	0.99 (0.76-1.27)	0.907	0.82 (0.63-1.07)	0.146
Model 4	20 (5.9)	0.46 (0.30-0.73)	< 0.001	0.52 (0.33-0.82)	0.005	0.53 (0.33-0.87)	0.011
Cancer
Model 1	241 (9.6)	1		1		1
Model 2	50 (6.3)	0.60 (0.44-0.81)	0.001	0.74 (0.55-1.01)	0.055	0.86 (0.62-1.21)	0.387
Model 3	57 (11.3)	1.31 (0.98-1.75)	0.067	1.02 (0.76-1.36)	0.904	1.01 (0.75-1.37)	0.928
Model 4	32 (9.4)	0.94 (0.65-1.36)	0.743	1.02 (0.70-1.47)	0.938	1.07 (0.71-1.61)	0.755
Others
Model 1	504 (47.8)	1		1		1
Model 2	130 (53.4)	0.94 (0.77-1.13)	0.492	1.03 (0.84-1.25)	0.799	0.93 (0.74-1.16)	0.506
Model 3	142 (53.4)	1.28 (1.06-1.55)	0.009	1.25 (1.04-1.51)	0.019	1.15 (0.95-1.40)	0.159
Model 4	69 (57.0)	1.09 (0.85-1.41)	0.483	1.14 (0.89-1.47)	0.312	0.89 (0.67-1.20)	0.453

Model 1: Mild to moderate nonalcoholic fatty liver disease (NAFLD) with normal alanine aminotransferase (ALT) level; Model 2: Mild to moderate NAFLD with elevated ALT Level; Model 3: Severe NAFLD with normal ALT level; Model 4: Severe NAFLD with elevated ALT Level. The multivariate model was adjusted for age, sex, race/ethnicity, body mass index, waist circumference, aspartate aminotransferase, albumin, triglyceride, total cholesterol, high-density lipoprotein cholesterol, smoking status, diabetes, hypertension, and sedentary lifestyle. Others: Chronic lower respiratory diseases, accidents (unintentional injuries), cerebrovascular diseases, Alzheimer’s diseases, diabetes mellitus, influenza and pneumonia, nephritis, nephrotic syndrome and nephrosis and all other causes (residual). CI: Confidence interval; HR: Hazard ratio.