African Americans Demonstrate Significantly Lower Serum Alanine Aminotransferase Compared to Non-African Americans

Varma, Adarsh; Trudeau, Sheri; Zhou, Yueren; Jafri, Syed Mohammed; Krajenta, Richard; Lamerato, Lois; Brown, Kimberly; Luzzi, Veronica; Lü, Mei; Gordon, Stuart C.

doi:10.1007/s40615-020-00916-2

Cited by 4 publications

(4 citation statements)

References 21 publications

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“…Many factors could affect the level of serum ALT, including but not limited to gender, age, and ethnicity. A recent study demonstrated that African Americans had significantly lower serum ALT compared to non-African Americans [ 20 ]. Older patients with diabetes and ALT levels ≤ 18.5 IU/L often have low muscle strength, independent of any associated metabolic disorders [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Postoperative Alanine Aminotransferase Levels Are Associated with Outcomes in Pediatric Patients Undergoing Total Cavopulmonary Connection

et al. 2022

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Background: This single-center, retrospective study aims to determine the association between alanine aminotransferase (ALT) and outcomes in pediatric patients undergoing total cavopulmonary connection (TCPC). Methods: In total, 256 pediatric patients undergoing TCPC were included and divided into a normal-ALT group and a high-ALT group. Clinical data were collected for comparisons between groups, and risk factors of high postoperative ALT were identified by univariate and multivariate analysis. A ROC analysis of the predictive value of postoperative ALT was conducted. Results: Compared to the normal-ALT group, the members of the high-ALT group were 1.6 years older and had significantly higher preoperative creatinine and direct bilirubin levels. The high-ALT group had increased fluid overload, higher vasoactive inotropic drug scores, and inferior central venous pressure. The short-term outcomes in the high-ALT group were markedly worse: they suffered a longer duration of mechanical ventilation (MV), had a higher ICU and hospital length of stay (LOS), and higher rates of mortality, infection, and reintubation. Prolonged ICU and hospital LOS, longer MV, and reintubation were identified as independent risk factors for high postoperative ALT. Postoperative ALT was of high value in predicting reintubation, MV, ICU LOS, and mortality. Conclusions: Elevated postoperative ALT levels are associated with poor short-term outcomes in pediatric patients undergoing TCPC.

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Section: Discussionmentioning

confidence: 99%

Postoperative Alanine Aminotransferase Levels Are Associated with Outcomes in Pediatric Patients Undergoing Total Cavopulmonary Connection

et al. 2022

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“…Ethnic differences in ALT levels have also been observed. 14 AST exists as two genetically and immunologically distinct isoenzymes, namely cytoplasmic AST and mitochondrial AST. 15 Both isoenzymes catalyze the same reaction albeit with different kinetics and share a sequence homology of approximately 45%.…”

Section: Aminotransferasesmentioning

confidence: 99%

Subnormal Serum Liver Enzyme Levels: A Review of Pathophysiology and Clinical Significance

Youssef,

2024

J Clin Transl Hepatol

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Subnormal levels of liver enzymes, below the lower limit of normal on local laboratory reports, can be useful diagnostically. For instance, subnormal levels of aminotransferases can be observed in vitamin B 6 deficiency and chronic kidney disease. Subnormal alkaline phosphatase levels may indicate the presence of hypophosphatasia, Wilson’s disease, deficiencies of divalent ions, or malnutrition. Subnormal levels of gamma glutamyl transferase may be seen in cases of acute intrahepatic cholestasis, the use of certain medications, and in bone disease. Finally, subnormal levels of 5′-nucleotidase have been reported in lead poisoning and nonspherocytic hemolytic anemia. The aim of this review is to bring attention to the fact that subnormal levels of these enzymes should not be ignored as they may indicate pathological conditions and provide a means of early diagnosis.

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“…An old study conducted among 7,495 white and 1,842 black participants without diabetes in the Atherosclerosis Risk in Communities Study found median ALT levels to be significantly higher in white participants than in black participants[ 20 ]. Conversely, a more recent study conducted among 6719 individuals found that African Americans had significantly lower ALT serum values than non-African Americans, irrespective of BMI levels[ 21 ]. Therefore, all the above listed modifiers cannot be neglected when establishing local reference ranges of ALT.…”

Section: History Of Transaminases and Reference Rangementioning

confidence: 99%

“…These authors found that the healthy ALT values were 33 IU/L for men and 25 IU/L for women[ 23 ]. Another study, conducted among 7,403 Koreans (average age: 48 years, 49.9% were male) reported that the upper limit of the healthy range of the serum ALT level was 31 IU/L for males and 23 IU/L for females[ 21 ]. Interestingly, this study also found that “An unhealthy normal ALT level”, [defined as patients with serum ALT level of 31–40 IU/L (males) or 23–40 IU/L (females)], was associated with a higher prevalence of the MetS and insulin resistance[ 24 ].…”

Section: History Of Transaminases and Reference Rangementioning

confidence: 99%

Alanine aminotransferase predicts incident steatotic liver disease of metabolic etiology: Long life to the old biomarker!

Lonardo

2024

World J Gastroenterol

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Alanine aminotransferase (ALT) serum levels increase because of hepatocellular damage. Metabolic dysfunction-associated fatty liver disease (MAFLD), which identifies steatotic liver disease (SLD) associated with ≥ 2 metabolic abnormalities, has prominent sexual differences. The Metabolic Syndrome defines a cluster comprising abdominal obesity, altered glucose metabolism, dyslipidemia, and hypertension. Male sex, body mass index, glucose, lipids, ferritin, hypertension, and age independently predict ALT levels among blood donors. Over the last few decades, the reference range of ALT levels has been animatedly debated owing to attempts to update sex-specific reference ranges. With this backset, Chen et al have recently published a study which has two main findings. First, > 80% of individuals with MAFLD had normal ALT levels. Second, there was a linear increasing trend in the association between cumulative excess high-normal ALT levels and the rate of incident MAFLD. This study has biologically credible findings. However, it inaccurately considered sex differences in the MAFLD arena. Therefore, future studies on SLD owing to metabolic dysfunction should adopt locally determined and prospectively validated reference ranges of ALT and carefully consider sex differences in liver enzymes and MAFLD pathobiology.

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African Americans Demonstrate Significantly Lower Serum Alanine Aminotransferase Compared to Non-African Americans

Cited by 4 publications

References 21 publications

Postoperative Alanine Aminotransferase Levels Are Associated with Outcomes in Pediatric Patients Undergoing Total Cavopulmonary Connection

Postoperative Alanine Aminotransferase Levels Are Associated with Outcomes in Pediatric Patients Undergoing Total Cavopulmonary Connection

Subnormal Serum Liver Enzyme Levels: A Review of Pathophysiology and Clinical Significance

Alanine aminotransferase predicts incident steatotic liver disease of metabolic etiology: Long life to the old biomarker!

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