Abstract:Introduction: Cardiovascular diseases (CVD) are major causes of mortality among U.S. Hispanic/Latino farmworkers. Since Hispanics/Latinos, in general, are twice as likely as non-Hispanic whites to have elevated alanine aminotransferase (ALT), a biomarker of suspected nonalcoholic fatty liver disease, it is vital to understand the CVD risk factor-ALT relationship in Hispanic/Latino farmworkers. This study investigated the elevated ALT status in Hispanic/Latino farmworkers and the relationships between ALT and CVD risk markers. Methods: In 210 Hispanic/Latino farmworkers (48% female; aged 35.2±9.2 years), fasting blood samples were measured for serum ALT, and elevated ALT was defined by >43 U/L. CVD risk markers were measured with standard methods and defined according to the definitions of metabolic syndrome. Results: The overall prevalence for elevated ALT was 12.4%. Significant linear upward trends across tertiles of serum ALT were observed for body mass index, waist circumference, fasting glucose, and triglycerides after adjusting for age and sex (all P-trend<0.05). Multinomial logistic regression, adjusting for age and sex, revealed that compared to individuals with the lowest ALT levels (tertile1), the adjusted odds ratios for overweight/obesity, prediabetes, elevated triglycerides, and metabolic syndrome were 3.2 (95% CI:1.2-8.6), 3.7 (95% CI:1.6-8.4), 3.0 (95% CI:1.5-6.2), and 2.7 (95% CI:1.3-5.6), respectively, for those in the highest ALT levels (tertile 3). No association was found between serum ALT and blood pressure or HDL-cholesterol. Conclusions: Our findings provide evidence for the high prevalence of elevated ALT levels in Hispanic/Latino farmworkers and suggest that increased serum ALT is associated with multiple markers of CVD risk.

Extracardiac uptake on SPECT MPI, seen with physiologic radiotracer distribution, benign or malignant neoplasm, infection, inflammation, or granulomatous disease, may confound the accuracy of MPI or lead to unsuspected pathology. A 38-year-old woman with end-stage renal disease on hemodialysis had SPECT MPI for renal transplant preoperative risk stratification, showing left anterior descending artery ischemia and an intense extracardiac soft tissue focus adjacent to the diaphragmatic right ventricle concerning for focal infection related to prior coronary or gastric surgeries or tumor. CT revealed focal herniation of liver containing a flash-fill hemangioma into the left hemithorax accounting for this focal uptake.

No abstract