TABLE 4.
Adjusted hazard ratios for the development of each type of cancer by the AST/ALT ratio category
|
Number of each type of cancer development Adjusted hazard ratios (95% confidence interval) |
|||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Abstainers | Occasional drinkers | Regular drinkers | |||||||||||||
| First | Second | Third | Fourth | Fifth | First | Second | Third | Fourth | Fifth | First | Second | Third | Fourth | Fifth | |
| Men | |||||||||||||||
| C15–C26 | 63 | 43 | 28 | 19 | 12 | 30 | 25 | 20 | 10 | 15 | 133 | 157 | 103 | 109 | 107 |
| 0.96 (0.59–1.56) | 0.79 (0.49–1.28) | Reference | 0.77 (0.43–1.39) | 0.75 (0.37–1.54) | 0.70 (0.38–1.30) | 0.69 (0.38–1.25) | Reference | 0.51 (0.24–1.11) | 1.68 (0.84–3.35) | 1.05 (0.80–1.38) | 1.06 (0.83–1.37) | Reference | 1.38 (1.06–1.81) | 1.72 (1.31–2.27) | |
| Esophageal cancer | 2 | 2 | 3 | 2 | 2 | 9 | 25 | 18 | 19 | 26 | |||||
| 0.56 (0.08–3.75) | 0.31 (0.05–1.98) | Reference | 0.46 (0.07–3.10) | 0.97 (0.13–7.10) | — a | 0.41 (0.18–0.94) | 0.96 (0.52–1.76) | Reference | 1.35 (0.70–2.57) | 2.46 (1.33–4.54) | |||||
| Gastric cancer | 23 | 15 | 12 | 8 | 5 | 14 | 8 | 8 | 5 | 6 | 37 | 54 | 29 | 41 | 41 |
| 1.07 (0.49–2.30) | 0.62 (0.28–1.35) | Reference | 0.56 (0.22–1.41) | 0.55 (0.18–1.68) | 0.59 (0.23–1.50) | 0.49 (0.18–1.33) | Reference | 0.57 (0.18–1.79) | 1.91 (0.63–5.75) | 1.20 (0.72–2.00) | 1.37 (0.87–2.16) | Reference | 1.81 (1.12–2.91) | 2.20 (1.36–3.57) | |
| Colon cancer | 26 | 15 | 7 | 6 | 3 | 9 | 6 | 6 | 4 | 8 | 49 | 46 | 37 | 23 | 22 |
| 1.28 (0.52–3.17) | 1.11 (0.45–2.75) | Reference | 1.18 (0.39–3.51) | 1.00 (0.26–3.92) | 0.93 (0.31–2.80) | 0.59 (0.19–1.85) | Reference | 0.64 (0.18–2.32) | 2.44 (0.82–7.23) | 0.99 (0.62–1.56) | 0.83 (0.54–1.29) | Reference | 0.82 (0.49–1.39) | 1.04 (0.61–1.77) | |
| C30–C39 | 21 | 19 | 9 | 8 | 2 | 6 | 11 | 7 | 7 | 4 | 31 | 42 | 34 | 34 | 20 |
| 1.01 (0.43–2.35) | 1.10 (0.49–2.46) | Reference | 1.02 (0.39–2.69) | 0.48 (0.10–2.31) | 0.36 (0.11–1.16) | 0.81 (0.31–2.11) | Reference | 1.02 (0.35–2.96) | 1.06 (0.30–3.78) | 0.92 (0.55–1.55) | 0.93 (0.59–1.47) | Reference | 1.31 (0.81–2.12) | 0.90 (0.51–1.59) | |
| Lung cancer | 18 | 15 | 8 | 5 | 2 | 6 | 9 | 5 | 6 | 4 | 26 | 38 | 30 | 28 | 17 |
| 1.04 (0.42–2.56) | 0.97 (0.40–2.31) | Reference | 0.71 (0.23–2.20) | 0.57 (0.12–2.74) | 0.52 (0.15–1.84) | 0.91 (0.30–2.74) | Reference | 1.16 (0.34–3.88) | 1.44 (0.37–5.68) | 0.86 (0.49–1.51) | 0.95 (0.59–1.55) | Reference | 1.23 (0.73–2.06) | 0.90 (0.49–1.65) | |
| C60–C63 | 46 | 59 | 38 | 23 | 12 | 30 | 29 | 23 | 17 | 8 | 81 | 133 | 77 | 67 | 57 |
| 0.82 (0.51–1.33) | 0.91 (0.60–1.39) | Reference | 0.65 (0.38–1.10) | 0.46 (0.23–0.90) | 0.77 (0.20–3.03) | 0.58 (0.14–2.34) | Reference | 1.23 (0.32–4.72) | 0.50 (0.05–4.78) | 1.28 (0.91–1.78) | 1.39 (1.04–1.84) | Reference | 1.11 (0.80–1.55) | 1.12 (0.79–1.59) | |
| Prostate cancer | 41 | 53 | 35 | 20 | 12 | 27 | 20 | 21 | 16 | 8 | 65 | 123 | 70 | 63 | 50 |
| 0.79 (0.48–1.30) | 0.87 (0.56–1.34) | Reference | 0.59 (0.34–1.04) | 0.50 (0.25–0.99) | 0.82 (0.44–1.52) | 0.52 (0.28–0.98) | Reference | 0.65 (0.33–1.27) | 0.73 (0.31–1.70) | 1.22 (0.85–1.75) | 1.45 (1.08–1.95) | Reference | 1.15 (0.82–1.62) | 1.08 (0.75–1.56) | |
| C64–C68 | 9 | 7 | 1 | 6 | 2 | 6 | 4 | 4 | 5 | 1 | 14 | 18 | 5 | 15 | 10 |
| 3.89 (0.46–32.9) | 3.86 (0.47–31.6) | Reference | 7.09 (0.84–59.8) | 5.26 (0.47–58.6) | 1.21 (0.31–4.64) | 1.14 (0.30–4.36) | Reference | 3.06 (0.89–10.5) | 0.32 (0.03–3.00) | 2.21 (0.77–6.39) | 2.42 (0.89–6.55) | Reference | 3.95 (1.43–10.9) | 3.35 (1.13–9.92) | |
| Kidney cancer | 3 | 5 | 1 | 2 | 1 | 2 | 2 | 1 | 4 | 0 | 7 | 4 | 2 | 3 | 5 |
| 0.88 (0.08–9.86) | 2.60 (0.30–22.7) | Reference | 2.54 (0.23–28.3) | 2.34 (0.14–38.3) | 0.54 (0.04–7.02) | 1.05 (0.09–12.0) | Reference | 5.46 (0.55–54.1) | — a | 1.48 (0.29–7.63) | 1.03 (0.19–5.66) | Reference | 2.09 (0.35–12.6) | 4.86 (0.92–25.8) | |
| Urinary tract/bladder cancer | 4 | 2 | 3 | 1 | 1 | 7 | 14 | 3 | 12 | 5 | |||||
| — a | 1.16 (0.23–5.91) | 0.50 (0.08–3.06) | Reference | 0.30 (0.03–2.97) | 0.71 (0.07–7.63) | 2.61 (0.65–10.6) | 3.57 (1.02–12.5) | Reference | 5.20 (1.46–18.5) | 2.64 (0.62–11.2) | |||||
| C81–C96 | 3 | 9 | 3 | 0 | 2 | 3 | 2 | 2 | 3 | 0 | 7 | 12 | 9 | 1 | 2 |
| 0.43 (0.08–2.46) | 1.66 (0.43–6.40) | Reference | — a | 0.96 (0.14–6.61) | 1.02 (0.15–6.87) | 0.60 (0.08–4.28) | Reference | 1.56 (0.25–9.58) | — a | 0.44 (0.15–1.28) | 0.83 (0.34–1.99) | Reference | 0.16 (0.02–1.29) | 0.42 (0.09–1.96) | |
| Unknown | 16 | 10 | 10 | 6 | 2 | 7 | 11 | 2 | 2 | 1 | 26 | 34 | 22 | 19 | 14 |
| 0.91 (0.36–2.32) | 0.65 (0.25–1.70) | Reference | 1.01 (0.35–2.92) | 0.55 (0.11–2.60) | 1.07 (0.20–5.62) | 2.47 (0.54–11.4) | Reference | 1.19 (0.16–8.57) | 1.55 (0.14–17.3) | 1.01 (0.55–1.84) | 1.08 (0.63–1.85) | Reference | 1.03 (0.55–1.92) | 1.06 (0.53–2.09) | |
| Women | |||||||||||||||
| C15–C26 | 11 | 44 | 60 | 69 | 61 | 3 | 20 | 19 | 20 | 15 | 6 | 16 | 30 | 33 | 46 |
| 0.48 (0.24–0.95) | 0.79 (0.53–1.18) | Reference | 0.92 (0.65–1.31) | 0.91 (0.63–1.31) | 0.61 (0.17–2.15) | 1.37 (0.71–2.64) | Reference | 0.92 (0.49–1.76) | 0.70 (0.35–1.41) | 1.00 (0.40–2.51) | 0.76 (0.41–1.40) | Reference | 0.78 (0.47–1.28) | 0.92 (0.58–1.47) | |
| Esophagus cancer | 0 | 2 | 2 | 5 | 4 | 2 | 0 | 1 | 2 | 6 | |||||
| — a | 1.39 (0.19–10.1) | Reference | 1.96 (0.37–10.4) | 1.31 (0.22–7.75) | — a | 18.1 (1.51–217) | — a | Reference | 1.34 (0.12–15.0) | 2.97 (0.35–25.1) | |||||
| Gastric cancer | 1 | 15 | 23 | 21 | 28 | 1 | 7 | 3 | 5 | 6 | 1 | 3 | 6 | 11 | 9 |
| 0.10 (0.01–0.76) | 0.66 (0.34–1.30) | Reference | 0.76 (0.42–1.38) | 1.18 (0.67–2.07) | 1.69 (0.15–18.8) | 4.26 (0.91–20.0) | Reference | 2.27 (0.46–11.2) | 2.95 (0.62–14.1) | 1.03 (0.11–9.27) | 0.69 (0.17–2.84) | Reference | 1.36 (0.50–3.71) | 0.96 (0.34–2.71) | |
| Colon cancer | 6 | 17 | 15 | 25 | 17 | 2 | 6 | 11 | 8 | 4 | 2 | 9 | 13 | 12 | 19 |
| 1.10 (0.40–2.99) | 1.24 (0.61–2.51) | Reference | 1.30 (0.68–2.47) | 0.98 (0.48–1.97) | 0.54 (0.11–2.71) | 0.64 (0.23–1.80) | Reference | 0.60 (0.24–1.50) | 0.30 (0.09–0.95) | 0.54 (0.11–2.58) | 0.94 (0.39–2.22) | Reference | 0.63 (0.29–1.40) | 0.88 (0.43–1.80) | |
| C30–C39 | 9 | 22 | 30 | 28 | 32 | 1 | 7 | 6 | 5 | 8 | 3 | 7 | 13 | 12 | 13 |
| 1.29 (0.59–2.81) | 0.87 (0.50–1.53) | Reference | 0.71 (0.42–1.19) | 0.88 (0.53–1.46) | 0.81 (0.09–6.95) | 1.47 (0.48–4.50) | Reference | 0.68 (0.20–2.28) | 1.26 (0.43–3.71) | 1.34 (0.36–5.02) | 0.68 (0.26–1.83) | Reference | 0.69 (0.31–1.53) | 0.67 (0.31–1.47) | |
| Lung cancer | 7 | 21 | 26 | 25 | 30 | 1 | 7 | 6 | 5 | 5 | 3 | 5 | 12 | 10 | 11 |
| 1.17 (0.49–2.79) | 0.96 (0.54–1.72) | Reference | 0.73 (0.42–1.26) | 0.94 (0.55–1.60) | 0.83 (0.10–7.17) | 1.45 (0.47–4.48) | Reference | 0.67 (0.20–2.24) | 0.79 (0.24–2.64) | 1.40 (0.37–5.35) | 0.61 (0.21–1.77) | Reference | 0.63 (0.27–1.48) | 0.62 (0.27–1.44) | |
| C50–C50 | 46 | 85 | 87 | 136 | 108 | 14 | 32 | 35 | 56 | 53 | 18 | 45 | 58 | 95 | 125 |
| 1.52 (1.03–2.22) | 1.03 (0.76–1.40) | Reference | 1.12 (0.86–1.47) | 0.93 (0.70–1.24) | 1.13 (0.58–2.17) | 1.14 (0.70–1.86) | Reference | 1.30 (0.85–1.99) | 1.08 (0.70–1.67) | 1.79 (1.02–3.14) | 1.11 (0.74–1.65) | Reference | 1.12 (0.81–1.56) | 1.15 (0.83–1.57) | |
| C51–C58 | 19 | 39 | 35 | 73 | 60 | 8 | 12 | 19 | 18 | 31 | 5 | 20 | 22 | 45 | 53 |
| 1.43 (0.78–2.60) | 1.24 (0.78–1.97) | Reference | 1.53 (1.02–2.30) | 1.32 (0.87–2.02) | 1.25 (0.52–2.99) | 0.80 (0.39–1.67) | Reference | 0.74 (0.39–1.42) | 1.08 (0.61–1.93) | 1.27 (0.46–3.50) | 1.40 (0.76–2.60) | Reference | 1.34 (0.79–2.27) | 1.22 (0.73–2.03) | |
| Cervical cancer | 4 | 10 | 10 | 21 | 26 | 2 | 2 | 10 | 7 | 15 | 0 | 10 | 8 | 19 | 22 |
| 1.16 (0.34–3.92) | 1.16 (0.48–2.81) | Reference | 1.50 (0.71–3.19) | 1.81 (0.87–3.78) | 0.59 (0.12–2.99) | 0.25 (0.05–1.17) | Reference | 0.53 (0.20–1.41) | 0.88 (0.39–1.98) | — a | 1.89 (0.74–4.82) | Reference | 1.48 (0.65–3.39) | 1.17 (0.52–2.65) | |
| Endometrial cancer | 5 | 7 | 8 | 21 | 12 | 0 | 5 | 2 | 4 | 8 | 1 | 6 | 3 | 7 | 7 |
| 1.50 (0.44–5.09) | 0.97 (0.35–2.70) | Reference | 2.06 (0.91–4.66) | 1.30 (0.53–3.20) | — a | 2.93 (0.56–15.4) | Reference | 1.34 (0.24–7.41) | 2.95 (0.62–14.1) | 2.32 (0.23–23.8) | 2.93 (0.73–11.8) | Reference | 1.48 (0.38–5.77) | 1.13 (0.29–4.39) | |
| Ovarian cancer | 5 | 5 | 9 | 8 | 9 | 3 | 1 | 1 | 3 | 1 | 2 | 2 | 5 | 3 | 6 |
| 1.92 (0.59–6.22) | 0.68 (0.23–2.06) | Reference | 0.64 (0.25–1.66) | 0.74 (0.29–1.87) | 8.10 (0.76–86.2) | 1.36 (0.08–22.1) | Reference | 2.44 (0.25–23.7) | 0.78 (0.05–12.7) | 1.36 (0.22–8.45) | 0.55 (0.10–2.91) | Reference | 0.45 (0.11–1.91) | 0.77 (0.23–2.59) | |
| C64–C68 | 1 | 9 | 11 | 4 | 8 | 1 | 2 | 3 | 4 | 3 | 1 | 2 | 2 | 4 | 4 |
| 0.26 (0.03–2.17) | 0.90 (0.36–2.21) | Reference | 0.29 (0.09–0.90) | 0.60 (0.24–1.52) | 0.73 (0.06–8.71) | 0.46 (0.07–3.15) | Reference | 1.30 (0.27–6.20) | 0.99 (0.19–5.17) | 3.12 (0.24–41.0) | 1.30 (0.18–9.49) | Reference | 1.56 (0.28–8.71) | 1.36 (0.24–7.62) | |
| Kidney cancer | 1 | 6 | 4 | 3 | 5 | ||||||||||
| 0.98 (0.10–9.28) | 1.73 (0.48–6.21) | Reference | 0.54 (0.12–2.45) | 0.93 (0.25–3.51) | — a | — a | |||||||||
| Urinary tract/bladder cancer | 0 | 3 | 7 | 1 | 3 | 1 | 2 | 2 | 2 | 1 | |||||
| — a | 0.38 (0.09–1.59) | Reference | 0.10 (0.01–0.87) | 0.34 (0.08–1.46) | 1.79 (0.12–26.9) | 0.82 (0.10–7.04) | Reference | 0.85 (0.11–6.84) | 0.40 (0.03–5.10) | — a | |||||
| C81–C96 | 2 | 5 | 8 | 11 | 6 | 0 | 0 | 4 | 4 | 3 | |||||
| 1.06 (0.22–5.24) | 0.71 (0.23–2.19) | Reference | 0.98 (0.39–2.45) | 0.59 (0.20–1.73) | — a | — a | — a | Reference | 0.70 (0.17–2.89) | 0.49 (0.10–2.28) | |||||
| Lymphoma | 1 | 3 | 7 | 10 | 4 | 0 | 0 | 3 | 4 | 2 | |||||
| 0.65 (0.08–5.44) | 0.47 (0.12–1.85) | Reference | 1.00 (0.38–2.65) | 0.47 (0.13–1.63) | — a | — a | — a | Reference | 0.70 (0.17–2.89) | 0.49 (0.10–2.28) | |||||
| D00–D09 | 3 | 6 | 8 | 13 | 8 | 1 | 2 | 2 | 2 | 8 | 1 | 4 | 3 | 7 | 6 |
| 1.02 (0.25–4.19) | 0.86 (0.30–2.49) | Reference | 1.11 (0.46–2.69) | 0.62 (0.23–1.68) | 1.59 (0.13–19.7) | 1.29 (0.17–9.56) | Reference | 0.70 (0.10–5.00) | 2.48 (0.50–11.4) | 2.60 (0.27–25.5) | 2.11 (0.47–9.54) | Reference | 1.58 (0.40–6.19) | 0.97 (0.24–3.97) | |
| Unknown | 9 | 15 | 16 | 13 | 16 | 4 | 6 | 5 | 6 | 6 | 1 | 1 | 5 | 8 | 14 |
| 1.84 (0.76–4.42) | 1.06 (0.52–2.16) | Reference | 0.56 (0.26–1.18) | 0.82 (0.41–1.65) | 3.06 (0.75–12.4) | 1.35 (0.40–4.50) | Reference | 0.97 (0.29–3.21) | 0.92 (0.28–3.04) | 1.48 (0.16–13.4) | 0.33 (0.04–2.83) | Reference | 1.11 (0.36–3.41) | 1.53 (0.55–4.29) | |
Models were adjusted for age; sex; body mass index; smoking status; alcohol consumption; exercise habits; medical histories of hypertension, diabetes, and fatty liver; family history of any type of cancer; and, the presence of hepatitis C virus (HCV) antibody, hepatitis B surface (HBs) antigen, and HBs antibody. The following cancers which had less than 10 cases in each sex/alcohol consumption status were omitted from the analyses due to the lack of statistical power. The numbers in bold represent that the p value is <0.05.
Abbreviations: ALT, alanine aminotransferase; AST, aspartate aminotransferase; C00–C14, lips, oral cavity, and pharynx; C40–C41, bone and articular cartilage; C43–C44, melanoma and other skin cancers; C45–C49, mesothelial and soft tissue; C69–C72, eye, brain, and other parts of the central nervous system; C73–C75, thyroid and other endocrine glands; C76–C80, ill‐defined, other secondary, and unspecified sites; duodenal cancer; gallbladder/bile duct cancer hepatocellular carcinoma; hepatocellular carcinoma; leukemiapancreatic cancer.
a
Hazard ratios could not be calculated due to an insufficient number of events.