Correlation Between Serum Alanine Aminotransferase Activity and Age: An Inverted U Curve Pattern

Elinav, Eran; Ben‐Dov, Iddo Z.; Ackerman, Elizabeth; Kiderman, Alexander; Glikberg, Frida; Shapira, Yami; Ackerman, Zvi

doi:10.1111/j.1572-0241.2005.41822.x

Cited by 97 publications

(74 citation statements)

References 7 publications

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“…Similar co relation between age and ALT activity was reported by previous report, where an inverted U like relation of ALT and age was revealed (Elinav et al, 2005). Some studies have reported significant association of ALT activity with gender, in the current study a significant difference in ALT activity with gender was found only among Non-Diabetics at p=0.005.…”

Section: Resultssupporting

confidence: 90%

Serum Alanine Aminotransferase (ALT) Activity among Diabetic Patients

Upadhayay

2016

Int J Appl Sci Biotechnol

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Serum Alanine aminotransferase (ALT) activity is the most common screening test as a part of routine assessment of liver damage. Due to its low activity in extra hepatic tissues an increase in serum ALT is more specific for liver disease. The liver pathology among diabetics is similar to that of alcoholic liver disease, including fatty liver, steatohepatitis, fibrosis, and cirrhosis. Thus, elevated serum ALT activity which is a common sign of liver disease is also observed more frequently in diabetics. This study has been designed with the aim to determine the association of serum ALT activity with diabetes mellitus. The study included 208 subjects attending Nepal police hospital during the time frame 6 th October 2009 to 4 th January 2010.The ALT activity in serum was determined by kit method, fasting and post prandial sugar was tested by GOD-POD method.Among the total diabetic subjects 43.26% were found to have elevated serum ALT activity (>40IU/L). Diabetic status was found to be significantly associated with ALT activity (p=0.04). In addition to diabetic status body mass index (BMI) was also significantly associated with ALT activity (p=0.02) and higher BMI increases the likelihood of elevated ALT. The association of ALT activity was found to be inverse and significant with age of the patient(r=-0.217, p=0.005). Physical activity was also found to be inversely associated with ALT activity(r=-0.149, p=0.03).

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Section: Resultssupporting

confidence: 90%

Serum Alanine Aminotransferase (ALT) Activity among Diabetic Patients

Upadhayay

2016

Int J Appl Sci Biotechnol

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“…However, no subanalysis was performed on the nondiabetic group for CVD-related death only; therefore, these results are not as pure as the other two studies. It appears that any proposed linear relationship between ALT and incident CVD is debatable, as others have recently shown that ALT may in fact exhibit a U-shaped association with total mortality 24,25 and unpublished data from our group (Ford et al) suggests that ALT's associations with CVD events may be similarly shaped with increased risk also apparent at low ALT concentrations. Thus, current evidence goes against a linear association of ALT with CVD events.…”

mentioning

confidence: 74%

Liver enzymes, nonalcoholic fatty liver disease, and incident cardiovascular disease: A narrative review and clinical perspective of prospective data

2010

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In recent years, a strong link has been established between nonalcoholic fatty liver disease (NAFLD) and the pathogenesis of type 2 diabetes mellitus. The potential role of NAFLD in cardiovascular disease (CVD) has also attracted interest. Published studies have tended to use biochemical and imaging surrogate markers of NAFLD, such as elevated gamma glutamyl transpeptidase (GGT) and alanine aminotransferase (ALT) and fatty liver on ultrasound, when investigating associations with incident CVD events. Positive associations between both baseline GGT and temporal change in GGT, as well as cardiovascular events and cardiovascular mortality independent of alcohol intake, have been reported in several prospective studies. However, adjustment for confounders is often incomplete, and there is scant evidence of improvement in cardiovascular risk prediction beyond established risk scores when incorporating such data. There also appears to be a strong and underrecognized age interaction, with associations between GGT and incident coronary heart disease (CHD) being strong in young individuals but relatively weak in the elderly. By contrast, ALT appears to be only weakly associated with incident CHD and may exhibit a U-shaped association with total mortality. Finally, although some studies have linked imaging-defined and biopsy-confirmed NAFLD with CVD risk, the evidence is inconsistent, with few incident events and/or insufficient potential confounders. Conclusion: A diagnosis of NAFLD is insufficient to consider patients as being at high risk for CVD. The presence of NAFLD should be a clear indication for diabetes screening, but cardiovascular risk screening should be performed with the use of existing risk calculators and should be guided by established cardiovascular risk factors.

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“…In addition, since the average ALT level for six of seven patients was Ͻ40 U/liter but Ͼ20 U/liter, these results illustrate the occurrence of host immune selection even with a slight increase in average ALT level. Although the cutoff of 20 U/liter may seem arbitrary, the ALT levels of hepatitis-free populations of different age groups have never exceeded this level (13,41). To this extent, an ALT level of 20 U/liter may represent the action of host immunity against HBV.…”

Section: Discussionmentioning

confidence: 99%

Distinct Hepatitis B Virus Dynamics in the Immunotolerant and Early Immunoclearance Phases

Wang

Chien

Huang

et al. 2010

J Virol

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Little is known about hepatitis B virus (HBV) diversity changes within a host during the immunotolerant phase of chronic HBV infection. Such knowledge, nevertheless, may help in understanding how host immunity and HBV interact at the early stage of infection. In this study, serial serum samples were collected from a long-term (>17 years) follow-up cohort of seven patients, and multiple copies of the full-length viral genome from serially sampled sera were recovered and analyzed. Viral genetic diversity was positively correlated with host immunity, represented by levels of alanine aminotransferase (ALT), but was negatively correlated with the viral copy number. During the immunotolerant phase, when the host immunity was feeble (ALT < 20 U/liter), viral nucleotide diversity decreased while copy numbers increased. Rates of evolutionary change derived for different patients were in a very narrow range (1.6 ؋ 10 ؊5 to 5.4 ؋ 10 ؊5 /site/year). As the disease progressed toward the immunoclearance phase (ALT > 20 U/liter), viral diversity increased but copy numbers decreased. Evolutionary rates varied among patients in accordance with their levels of ALT, ranging from 9.6 ؋ 10 ؊6 to 3.2 ؋ 10 ؊4 /site/year. More than half (19/32 sites) of positively selected sites resided in immune epitopes, suggesting their possible role in host immunity. Our results demonstrate that host immunity is a dominant factor in HBV evolution. Different selective forces, including immune-mediated positive selection and virus-mediated negative selection, operate in tandem in shaping viral population dynamics within a host.

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Correlation Between Serum Alanine Aminotransferase Activity and Age: An Inverted U Curve Pattern

Cited by 97 publications

References 7 publications

Serum Alanine Aminotransferase (ALT) Activity among Diabetic Patients

Serum Alanine Aminotransferase (ALT) Activity among Diabetic Patients

Liver enzymes, nonalcoholic fatty liver disease, and incident cardiovascular disease: A narrative review and clinical perspective of prospective data

Distinct Hepatitis B Virus Dynamics in the Immunotolerant and Early Immunoclearance Phases

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