title: Factors underlying the association of body mass index with serum ALT in Chinese hypertensive adults without known hepatic diseases.
abstract: OBJECTIVE
  High body mass index (BMI) is considered as the most important risk factor for elevated serum alanine aminotransferase (ALT) concentration. This study examined an array of factors, including waist circumference (WC) and folate deficiency, which may mediate the association of BMI with serum ALT concentration in Chinese hypertensive adults without known hepatic diseases.
  
  
  METHODS
  A multicenter, cross-sectional study was carried out. A total of 378 patients with mild or moderate hypertension and without known hepatic diseases were recruited from five hospitals in Harbin, Shanghai, Beijing, Xi'an, and Nanjing.
  
  
  RESULTS
  Of the 360 hypertensive patients with complete data in our final analysis, 13.6% had high ALT concentrations (>40 IU/L). Factors including BMI, WC, triglyceride level, and folate concentration were associated with ALT concentration in univariate analysis. Consistently higher prevalence rates of elevated ALT were observed in subjects with lower folate concentrations (≥12 vs. <12 nmol/L, 9.9% vs. 17.8%, P=0.03), with higher BMI (≥28 vs. <28 kg/m(2), 21.5% vs. 11.4%, P=0.02) or higher WC (≥90 vs. <90 cm, 18.5% vs. 10.0%, P=0.02). However, in multivariate analysis, the association between BMI and ALT concentration disappeared (P=0.802 in males and 0.369 in females), while WC in females (P<0.001) and folate concentration (P=0.036 in males and 0.044 in females) remained as significant predictors for ALT concentration.
  
  
  CONCLUSIONS
  This multicenter study demonstrated that WC and low folate concentration were important factors underlying the association between BMI and ALT concentrations in Chinese hypertensive adults without known hepatic diseases.
authors.affiliation: Department of Cardiology, Peking University First Hospital, Beijing 100034, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.forename: Xian-hui
authors.initials: XH
authors.lastname: Qin
authors.forename: Jian-ping
authors.initials: JP
authors.lastname: Li
authors.forename: Yi-min
authors.initials: YM
authors.lastname: Cui
authors.forename: Ze-yuan
authors.initials: ZY
authors.lastname: Liu
authors.forename: Zhi-gang
authors.initials: ZG
authors.lastname: Zhao
authors.forename: Jun-bo
authors.initials: JB
authors.lastname: Ge
authors.forename: De-ming
authors.initials: DM
authors.lastname: Guan
authors.forename: Jian
authors.initials: J
authors.lastname: Hu
authors.forename: Yan-ni
authors.initials: YN
authors.lastname: Wang
authors.forename: Fu-min
authors.initials: FM
authors.lastname: Zhang
authors.forename: Xin
authors.initials: X
authors.lastname: Xu
authors.forename: Xi-ping
authors.initials: XP
authors.lastname: Xu
authors.forename: Yong
authors.initials: Y
authors.lastname: Huo
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D044466:Asian People; D015992:Body Mass Index; D002681:China; D003430:Cross-Sectional Studies; D005260:Female; D005492:Folic Acid / Q000097:blood; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000201:enzymology* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D055105:Waist Circumference
chemical_list: D014280:Triglycerides; D005492:Folic Acid; D000410:Alanine Transaminase
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