Gender difference of alanine aminotransferase elevation may be associated with higher hemoglobin levels among male adolescents.
BACKGROUND
To explore the gender difference of ALT elevation and its association with high hemoglobin levels.


METHODS
A cross-sectional study of 3547 adolescents (2005 females, mean age of 16.5?.3 years) who were negative for hepatitis B surface antigen received health checkups in 2006. Body mass index (BMI), levels of hemoglobin, ALT and cholesterol were measured. ALT >42 U/L was defined as elevated ALT. Elevated ALT levels were detected in 112 of the 3547 participants (3.3%), more prevalent in males than in females (5.4% vs. 1.4%, p<0.001). Hemoglobin levels had a significant linear correlation with ALT levels in both genders. Abnormal ALT started to occur if hemoglobin >11 g/dl in females or >13.5 g/dl in males, but the cumulative cases of elevated ALT increased more quickly in males. Proportion of elevated ALT increased as either the BMI or hemoglobin level rise, more apparent in male adolescents. Logistic regression modeling showed odds ratio (95% confidence interval) were 24.7 (15.0-40.6) for BMI ≥27 kg/m(2); 5.5 (2.9-10.4) for BMI 24-27 kg/m(2); 2.7 (1.3-5.5) for Q5 (top 20th percentile) hemoglobin level; and 2.6 (1.6-4.1) for male gender. Further separately fitting the logistic models for two genders, the significance of Q5 hemoglobin level only appeared in the males.


CONCLUSIONS
High hemoglobin level is a significant risk factor of ALT elevation after control hepatitis B, obesity and gender. Males have greater risk of abnormal liver function which may be associated with higher hemoglobin levels.
Department of Pediatrics, Pingtung Christian Hospital, Pingtung, Taiwan.
Solomon Chih-Cheng
SC
Chen
Jun-Jun
JJ
Yeh
Mei-Hwei
MH
Chang
Yu-Kuei
YK
Liao
Li-Chen
LC
Hsiao
Choo-Aun
CA
Neoh
Teck-Siang
TS
Tok
Jung-Der
JD
Wang
D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood*; D015992:Body Mass Index; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D016015:Logistic Models; D008297:Male; D012307:Risk Factors; D012737:Sex Factors
D006454:Hemoglobins; D000410:Alanine Transaminase