title: Evaluation of reference intervals for biomarkers sensitive to alcohol consumption, excess body weight and oxidative stress.
abstract: BACKGROUND
  Unexplained liver enzyme activities are often found in health screening programs and constitute an increasingly common cause for referral to specialized clinics. Recent studies have indicated that both excess body weight and alcohol consumption may lead to metabolic aberrations which are readily reflected in the activities of liver enzymes in circulation.
  
  
  METHODS
  We compared various laboratory markers and their upper normal limits in relation to information on alcohol consumption and BMI in a large population of apparently healthy individuals collected from Nordic countries.
  
  
  RESULTS
  Based on the data obtained from normal weight abstainers (BMI 19-25 kg/m(2)) the upper normal limits in men should be 50 U/L for ALT, and 45 U/L (<40 years) and 70 U/L (>or=40 years) for GGT, while the current recommendations are 70 U/L, 80 U/L, and 115 U/L, respectively. Already in comparisons between normal weight abstainers and corresponding moderate drinkers notable impacts (+14% - +74%) on upper limits for these analytes were seen, which further grew when adiposity occurred together with alcohol drinking (+75% - +186%, BMI >or=27 kg/m(2)). In addition to liver enzymes, similar changes were also found for uric acid.
  
  
  CONCLUSIONS
  Alcohol consumption and excess body weight even in apparently healthy individuals have a significant influence on liver enzyme activities, which may be due to a cumulative oxidative stress burden. The metabolic changes induced by adiposity or ethanol intake should be considered in the definition of normal ranges for all laboratory parameters sensitive to oxidative stress.
authors.affiliation: Department of Laboratory Medicine and Medical Research Unit, Seinäjoki Central Hospital, Seinäjoki, Finland. paivikki.alatalo@epshp.fi
authors.forename: Päivikki
authors.initials: P
authors.lastname: Alatalo
authors.forename: Heidi
authors.initials: H
authors.lastname: Koivisto
authors.forename: Johanna
authors.initials: J
authors.lastname: Kultti
authors.forename: Risto
authors.initials: R
authors.lastname: Bloigu
authors.forename: Onni
authors.initials: O
authors.lastname: Niemelä
mesh_terms: D000293:Adolescent; D000328:Adult; D000375:Aging / Q000097:blood; D000410:Alanine Transaminase / Q000097:blood; D000428:Alcohol Drinking / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000097:blood*; D018384:Oxidative Stress; D012016:Reference Values; D012306:Risk; D012727:Sex Characteristics; D014280:Triglycerides / Q000097:blood; D014527:Uric Acid / Q000097:blood; D055815:Young Adult; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D008076:Cholesterol, HDL; D014280:Triglycerides; D014527:Uric Acid; D002784:Cholesterol; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D003402:Creatine Kinase