Normal Limit for Serum Alanine Aminotransferase Level and Distribution of Metabolic Factors in Old Population of Kalaleh, Iran

Abstract

BackgroundsNormal or elevated values of serum alanine aminotransferase level (ALT) vary in different studies mostly related to characteristics of reference population including age, gender, body mass index, nonalcoholic fatty liver disease (NAFLD), and metabolic syndrome prevalence.ObjectivesTo measure upper normal limit (UNL) for serum ALT in an apparently healthy Iranian old population (which we had not sufficient data before this study), and its modulating factors.Patients and MethodsAll inhabitants (> 50 years old) of Kalaleh, Golestan, Iran (N = 1986) were invited to the study. ALT measurements were performed for all subjects using the same laboratory method. Upper limit of normal (ULN) ALT was calculated based on its 95th percentile in normal weight subjects. Modulating factors of ALT were determined by multivariate analysis.ResultsA total of 1309 subjects, with the mean age of 61.5 ± 7.5 years were included. UNL of ALT was 18.8 U/L and 21.4 U/L in women and men, respectively. Based on univariate analysis, waist circumference (r = 0.124, P = 0.01), body mass index (r = 0.118, P = 0.01), triglyceride (r = 0.143, P = 0.01), and having metabolic syndrome (OR = 2.04) modulate ALT levels in men. Also triglyceride (r = 0.119, P = 0.01) modulates ALT levels in women.ConclusionsThe calculated level for UNL of ALT is considerably far lower than previous accepted value. Age, gender, ethnicity, and metabolic factors should be accounted in future studies to determine normal ALT level.

Upper Normal Limit of Serum Alanine Aminotransferase and Its Association with Metabolic Risk Factors in Pars Cohort Study

“…Lack of any information about participants with NAFLD was another point that must be considered. 2,11 In addition, differences between laboratories and various detection kits of ALT may cause test heterogeneity in different studies and regions. 10 All MS components were positively correlated with an increase in the serum ALT.…”

“…Serum alanine aminotransferase (ALT), as a hepatic-predictive value for chronic metabolic diseases, is an important factor for screening non-alcoholic fatty liver disease (NAFLD). 1,2 However, its range varies in different populations based on age, sex, ethnicity, body mass index (BMI), the prevalence of NAFLD, serum levels of low-density lipoprotein (LDL), and components of metabolic syndrome (MS). [3][4][5][6] Therefore, population-specific cut-offs for ALT may provide a more effective screening tool for NAFLD in each population.…”

“…[9][10][11] There are controversies on the cut-off point of ALT in Iranian adults and the correlation of available cut-offs with NAFLD, MS, or other chronic diseases. 2,12,13 We analyzed the baseline data of the participants of Pars Cohort Study to investigate the normal range of ALT and its association with MS in a semi-urban population in southern Iran.…”

Association of rs780094 polymorphism of glucokinase regulatory protein with non-alcoholic fatty liver disease

“…It has known that anthropometric parameters not only related to the genetic background but also dependent on lifestyle. In a study on Iranian population, it has been shown a relationship among NAFLD, age, gender, obesity, metabolic syndrome, triglycerides, higher glucose, blood pressure and waist circumference [19]. Bhatt et al [20] reported lack of any signi cant correlation between age and NAFLD in Asian Indians.…”

The expression of thymosin β4 in chronic hepatitis B combined nonalcoholic fatty liver disease

“…[25] Clinically, it was found that in patients with NAFLD, the ALT level was influenced by age, gender, metabolic factor, and so on. [26] Therefore, the ALT level could not be used to confirm the reason of inflammation, and also could not reflect the conditions of real inflammation in the hepatic cells. Thus, it was urgent to seek a more specific factor which could reflect the inflammatory condition.…”