Which Liver Enzymes Are Better Indicators of Metabolic Syndrome in Adolescents: The Fifth Korea National Health and Nutrition Examination Survey, 2010

Lee, Kayoung; Yang, Jin

doi:10.1089/met.2012.0153

Cited by 34 publications

(44 citation statements)

References 31 publications

(55 reference statements)

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“…We found that high BMI and dyslipidemia were factors associated with NAFLD in the hemodialysis patients, while high BMI, high ALT, and low LSM were factors associated with NAFLD in the control group patients. Previous studies have shown that ALT was found to be associated with the clustering of metabolic syndrome components [29,30]. The clinical factors associated with NAFLD in both the hemodialysis and control group patients in this study were compatible with the aforementioned AASLD guidelines [24].…”

Section: Discussionsupporting

confidence: 82%

Using controlled attenuation parameter combined with ultrasound to survey non-alcoholic fatty liver disease in hemodialysis patients: A prospective cohort study

et al. 2017

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Background and aimsControlled attenuation parameter (CAP) is a non-invasive method for measuring hepatic steatosis (HS). Non-alcoholic fatty liver disease (NAFLD) is closely related to cardiovascular diseases (CVDs). CVDs are the leading cause of morbidity and mortality in hemodialysis patients. The aim of this study was to investigate the prevalence of NAFLD in hemodialysis patients.MethodWe prospectively enrolled patients undergoing chronic hemodialysis, as well as patients with normal renal function who served as controls. The control group patients were referred by an endocrinologist to be tested for NAFLD; most of these patients had diabetes, hypertension, or dyslipidemia. We excluded those with excess alcohol intake, use of drugs known to induce HS, chronic viral hepatitis, or CAP failure. CAP ≥ 238 dB/m was used as a cutoff suggesting HS. An increased liver kidney contrast, as defined by ultrasound, was used to make the diagnosis of HS.ResultsThree hundred and forty-three hemodialysis patients and 252 control group patients were enrolled. Among the hemodialysis patients, 192 (56.0%) had CAP- or ultrasound-identified HS compared with 91 (26.5%) who only had ultrasound-identified HS (P<0.001). Among the control group patients, 212 (84.1%) had CAP- or ultrasound-identified HS compared with 180 (71.4%) who only had ultrasound-identified HS (P<0.001).ConclusionsThe prevalence of NAFLD in the hemodialysis patients was 56%. The number of diagnoses of NAFLD made by using CAP combined with ultrasound was more than 2 times the number made with ultrasound alone in the hemodialysis patients. Therefore, we suggest the use of CAP combined with ultrasound to screen for NAFLD in hemodialysis patients.

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Section: Discussionsupporting

confidence: 82%

Using controlled attenuation parameter combined with ultrasound to survey non-alcoholic fatty liver disease in hemodialysis patients: A prospective cohort study

et al. 2017

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“…Despite strong evidence about the association between the AST-to-ALT ratio and obesity-related metabolic disorders, there have been little data from prospective studies based on the incremental predictive value of the serum AST-to-ALT ratio for the onset of metabolic syndrome [10, 23]. In our study, an increasing AST-to-ALT ratio was correlated with a consistent reduction in the onset of metabolic syndrome and its components.…”

Section: Discussioncontrasting

confidence: 49%

“…An increased AST-to-ALT ratio is strongly suggestive of alcoholic liver disease, whereas a reduced ratio specifies non-alcoholic steatohepatitis [9]. Recent studies have reported that an increased AST-to-ALT ratio is inversely associated with the future development of metabolic syndrome [10, 11]. However, the clinical utility and ability of the AST-to-ALT ratio in predicting metabolic syndrome and its individual components is not well understood.…”

Section: Introductionmentioning

confidence: 99%

Incremental Predictive Value of Serum AST-to-ALT Ratio for Incident Metabolic Syndrome: The ARIRANG Study

et al. 2016

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AimsThe ratio of aspartate aminotransferase (AST) to alanine aminotransferase (ALT) is of great interest as a possible novel marker of metabolic syndrome. However, longitudinal studies emphasizing the incremental predictive value of the AST-to-ALT ratio in diagnosing individuals at higher risk of developing metabolic syndrome are very scarce. Therefore, our study aimed to evaluate the AST-to-ALT ratio as an incremental predictor of new onset metabolic syndrome in a population-based cohort study.Material and MethodsThe population-based cohort study included 2276 adults (903 men and 1373 women) aged 40–70 years, who participated from 2005–2008 (baseline) without metabolic syndrome and were followed up from 2008–2011. Metabolic syndrome was defined according to the harmonized definition of metabolic syndrome. Serum concentrations of AST and ALT were determined by enzymatic methods.ResultsDuring an average follow-up period of 2.6-years, 395 individuals (17.4%) developed metabolic syndrome. In a multivariable adjusted model, the odds ratio (95% confidence interval) for new onset of metabolic syndrome, comparing the fourth quartile to the first quartile of the AST-to-ALT ratio, was 0.598 (0.422–0.853). The AST-to-ALT ratio also improved the area under the receiver operating characteristic curve (AUC) for predicting new cases of metabolic syndrome (0.715 vs. 0.732, P = 0.004). The net reclassification improvement of prediction models including the AST-to-ALT ratio was 0.23 (95% CI: 0.124–0.337, P<0.001), and the integrated discrimination improvement was 0.0094 (95% CI: 0.0046–0.0143, P<0.001).ConclusionsThe AST-to-ALT ratio independently predicted the future development of metabolic syndrome and had incremental predictive value for incident metabolic syndrome.

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“…In Korea, elevated liver enzymes were associated with MS. ALT and the AST-to-ALT ratio were associated with clustering of MS components in Korean adolescents [19]. Serum ALT levels were correlated with the component of MS in Korean postmenopausal women [20].…”

Section: Introductionmentioning

confidence: 99%

Association between Serum Liver Enzymes and Metabolic Syndrome in Korean Adults

Kim

Han

2018

IJERPH

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The purpose of this study was to evaluate the association between alanine aminotransferase (ALT) and aspartate aminotransferase (AST), and metabolic syndrome (MS) in the Korean population. A total of 11,587 adults ≥30 years of age and with complete data were selected from Korea National Health and Nutrition Examination Survey VI conducted from 2013 to 2015. Normal ALT and AST levels were divided into quartiles, and their associations with MS were assessed by logistic regression analysis. Elevated levels of ALT [adjusted odds ratio (aOR) = 7.90, 95% confidence interval (CI) = 6.50–9.60] and AST (aOR = 3.81, 95% CI = 3.10–4.74) were both significantly associated with a higher prevalence of MS. The quartile group containing the highest levels of ALT and AST within the normal range also showed an increased risk of MS and its components. Elevated levels of ALT and AST, even within the normal range, were associated with prevalence of MS.

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Which Liver Enzymes Are Better Indicators of Metabolic Syndrome in Adolescents: The Fifth Korea National Health and Nutrition Examination Survey, 2010

Abstract: ALT, AST/ALT, and GGT were found to be associated with clustering of metabolic syndrome components, and the relationships appear to be sex- and weight group-specific.

Cited by 34 publications

References 31 publications

Using controlled attenuation parameter combined with ultrasound to survey non-alcoholic fatty liver disease in hemodialysis patients: A prospective cohort study

Using controlled attenuation parameter combined with ultrasound to survey non-alcoholic fatty liver disease in hemodialysis patients: A prospective cohort study

Incremental Predictive Value of Serum AST-to-ALT Ratio for Incident Metabolic Syndrome: The ARIRANG Study

Association between Serum Liver Enzymes and Metabolic Syndrome in Korean Adults

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