title: The association between increased alanine aminotransferase activity and metabolic factors in nonalcoholic fatty liver disease.
abstract: Nonalcoholic fatty liver disease (NAFLD) has been associated with metabolic disorders, including central obesity, dyslipidema, hypertension, and hyperglycemia. Metabolic syndrome, obesity, and insulin resistance are major risk factors in the pathogenesis of NAFLD. The aim of this study was to identify the relative contribution of the metabolic syndrome, obesity, and insulin resistance to alanine aminotransferase (ALT) activity in NAFLD. A total of 3091 subjects diagnosed with fatty liver by ultrasonography were enrolled. All components of metabolic syndrome criteria, anthropometric parameters, fasting insulin levels, high-sensitivity C-reactive protein (hs-CRP) as an inflammation marker, and ALT were measured in each subject. Homeostasis model assessment--insulin resistance (HOMA-IR) as a measure of insulin resistance and body mass index (BMI) as a measure of obesity were calculated. The prevalence of increased ALT levels (>40 IU/L) was 26.7%. Increased ALT activity was significantly associated with the following characteristics: male sex, young age, increased triglycerides, fasting glucose, fasting insulin, HOMA-IR, hs-CRP, waist circumference, BMI and diastolic blood pressure, and decreased high-density lipoprotein cholesterol (HDL-C). According to the increase in the number of metabolic syndrome components, BMI, HOMA-IR, and hs-CRP, the prevalence and odds ratio for having increased ALT activity were significantly increased. Central obesity, raised triglycerides, reduced HDL-C, and raised fasting glucose were strongly associated with increased ALT activity. In conclusion, a number of metabolic syndrome components, obesity, insulin resistance, and hs-CRP, are strong predictors of increased ALT activity in NAFLD. Central obesity, raised triglycerides, reduced HDL-C, and raised fasting glucose are metabolic syndrome components that contributed to increased ALT activity.
authors.affiliation: Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 110-746, South Korea.
authors.forename: Se-Yong
authors.initials: SY
authors.lastname: Oh
authors.forename: Yong-Kyun
authors.initials: YK
authors.lastname: Cho
authors.forename: Mun-Su
authors.initials: MS
authors.lastname: Kang
authors.forename: Tae-Woo
authors.initials: TW
authors.lastname: Yoo
authors.forename: Jung-Ho
authors.initials: JH
authors.lastname: Park
authors.forename: Hong-Joo
authors.initials: HJ
authors.lastname: Kim
authors.forename: Dong-Il
authors.initials: DI
authors.lastname: Park
authors.forename: Chong-Il
authors.initials: CI
authors.lastname: Sohn
authors.forename: Woo-Kyu
authors.initials: WK
authors.lastname: Jeon
authors.forename: Byung-Ik
authors.initials: BI
authors.lastname: Kim
authors.forename: Byung-Ho
authors.initials: BH
authors.lastname: Son
authors.forename: Jun-Ho
authors.initials: JH
authors.lastname: Shin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D008076:Cholesterol, HDL / Q000097:blood; D005234:Fatty Liver / Q000000981:diagnostic imaging / Q000201:enzymology*; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D024821:Metabolic Syndrome / Q000201:enzymology*; D008875:Middle Aged; D009765:Obesity / Q000201:enzymology; D014280:Triglycerides / Q000097:blood; D014463:Ultrasonography
chemical_list: D008076:Cholesterol, HDL; D014280:Triglycerides; D002097:C-Reactive Protein; D000410:Alanine Transaminase