Determinants of alanine aminotransferase levels in a large population from Southern Italy: Relationship between alanine aminotransferase and age

Gentilucci, Umberto Vespasiani; Gallo, Paolo; Piccinocchi, Gaetano; Piccinocchi, Roberto; Schena, Emiliano; Galati, Giovanni; Vincentis, Antonio De; Dell’Unto, C.; Picardi, Antonio

doi:10.1016/j.dld.2014.05.021

Cited by 19 publications

(13 citation statements)

References 29 publications

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“…We found no association between sex and log ALT. This contrasts with other studies that reported lower baseline ALT levels in females [22,23]. It is possible that the small sex-related differences in normal subjects did not translate to a detectable difference in pathological states.…”

Section: Discussioncontrasting

confidence: 90%

“…A similar finding was noted by Ray et al, who also noted an ordinal relationship between ALT and CKD stage [28]. In the large Italian study of general practice patients, a higher serum creatinine was associated with a lower ALT [23]. The mechanism is unknown but may be related to pyridoxine deficiency [29] or inhibition of aminotransferase activity by uremic solutes [30].…”

Section: Discussionsupporting

confidence: 73%

“…The authors also found no correlation between age and AST [22]. Vespasian-Gentilucci et al, reporting a large Italian study of over 44000 general practice subjects, noted a similar finding of an inverted parabolic relationship between age and ALT, with a peak in the third to fifth decade [23]. In our study, using a quadratic term did not improve the model fit when regressing log ALT on age.…”

Section: Discussionsupporting

confidence: 73%

“…It is possible that the small sex-related differences in normal subjects did not translate to a detectable difference in pathological states. Other studies have also suggested that overweight and obesity are associated with elevated aminotransferases, using body mass index and other metabolic markers to correlate with ALT [23,34,35]. However, we were not able to address this due to missing data on body mass index.…”

Section: Discussionmentioning

confidence: 82%

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A Cross-Sectional Study of the Relationship between Serum Creatine Kinase and Liver Biochemistry in Patients with Rhabdomyolysis

Lim

Arumugananthan

Yim

et al. 2019

JCM

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Abnormal liver function tests are commonly observed with rhabdomyolysis, but the nature of this association is not fully defined. This study aims to determine the functional relationship between serum creatine kinase, as a marker of rhabdomyolysis severity, and liver biochemistry. We used linear regression to model the relationship between liver biochemistry and peak serum creatine kinase. A total of 528 patients with a median age of 74 years were included. The distribution of creatine kinase, bilirubin, alkaline phosphatase, alanine aminotransferase, and γ-glutamyl transferase were significantly skewed, and these variables were log-transformed prior to regression. There was a positive linear correlation between log-alanine aminotransferase and log-creatine kinase. In the multiple regression analysis, log-creatine kinase, age, acute kidney injury stage, and chronic liver disease were independently associated with log-alanine aminotransferase. This model explained 46% of the variance of log-alanine aminotransferase. We found no correlation between the log-creatine kinase and the log-bilirubin, log-alkaline phosphatase, or log-γ-glutamyl transferase. Serum alanine aminotransferase was not associated with inpatient mortality but a higher creatine kinase-alanine aminotransferase ratio was associated with lower odds of mortality. In conclusion, an isolated elevation in alanine aminotransferase can occur in rhabdomyolysis, and it may be possible to anticipate the level of increase based on the peak creatine kinase.

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Section: Discussioncontrasting

confidence: 90%

Section: Discussionsupporting

confidence: 73%

Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 82%

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A Cross-Sectional Study of the Relationship between Serum Creatine Kinase and Liver Biochemistry in Patients with Rhabdomyolysis

Lim

Arumugananthan

Yim

et al. 2019

JCM

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“…An inversed relationship between age and ALT is reported [17], which has been associated with male sex in particular [4]. An inverse U-shaped relationship between age and ALT is demonstrated in Israeli and Italian cohorts of men and women recruited from general practice populations [18,19]. The purpose of the present study was to investigate the relationship between age and ALT by sex in a Scandinavian predominantly Caucasian general population and to identify CVD-related risk factor(s) most strongly associated with ALT.…”

Section: Introductionmentioning

confidence: 85%

Serum alanine aminotransferase activity is age- and sex-depended but independently predicted by body mass index in both sexes. The Tromsø study

Bekkelund¹

2020

Preprint

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Background High and low levels of serum alanine aminotransferase (ALT) are associated with cardiovascular diseases (CVD) especially in elderly but the roles of sex and age are unexplained. This study investigated sex- and age-related variation of serum ALT and associations between ALT and CVD risk factors in men and women in a Caucasian population. Methods This study used cross-sectional data from Tromsø 6 in 2555 men (mean age 60.4 years) and 2858 women (mean age 60.0 years). Associations were assessed by variance analysis and multivariable logistic regression of odds to have abnormal ALT. Results Abnormal ALT was detected in 113 (4.4%) men and 188 (6.6%) women. ALT correlated negatively with age in men (r = -0.231, p < 0.001) and positively in women (r = 0.124, p < 0.001). A linear inversed association between age and ALT in men and a non-linear inversed U-trend in women with maximum level between 60–64 years were found. Age was independently associated with ALT in men only [OR 1.05 (95% CI 1.04, 1.07), p < 0.001] and body mass index (BMI) was independently associated with ALT in both sexes. Conclusion The relationship between age and ALT was opposite directed in men compared to women, and linearly and independently in men only. Neither BMI as the strongest associated CVD risk factor in both sexes nor other risk components could explain this. Separate sex-analyses should be used in studies investigating the role of ALT as a disease marker.

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Age Impacts Ability of Aspartate–Alanine Aminotransferase Ratio to Predict Advanced Fibrosis in Nonalcoholic Fatty Liver Disease

et al. 2015

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With advancing age, ALT levels progressively declined while AST levels remained stable, leading to a higher AAR. Although higher AAR is often used as a surrogate measure of advanced fibrosis, advancing age can also contribute to increased AAR. In fact, an AAR ≥ 1 was found in significant number of elderly patients without advanced fibrosis. Consequently, an increased AAR may be a function of decreasing ALT with age in addition to progressive fibrosis.

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Determinants of alanine aminotransferase levels in a large population from Southern Italy: Relationship between alanine aminotransferase and age

Cited by 19 publications

References 29 publications

A Cross-Sectional Study of the Relationship between Serum Creatine Kinase and Liver Biochemistry in Patients with Rhabdomyolysis

A Cross-Sectional Study of the Relationship between Serum Creatine Kinase and Liver Biochemistry in Patients with Rhabdomyolysis

Serum alanine aminotransferase activity is age- and sex-depended but independently predicted by body mass index in both sexes. The Tromsø study

Age Impacts Ability of Aspartate–Alanine Aminotransferase Ratio to Predict Advanced Fibrosis in Nonalcoholic Fatty Liver Disease

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