title: Longitudinal association of obesity, metabolic syndrome and diabetes with risk of elevated aminotransferase levels in a cohort of Mexican health workers.
abstract: OBJECTIVE
  In Mexico, chronic liver disease have been increasingly found along with the rapidly growing prevalence of obesity, diabetes and metabolic syndrome (MS). We aimed to investigate the longitudinal association between these three factors and risk of elevated alanine aminotransferase (ALT) levels (>40 U/L), a marker for liver damage, in a cohort of Mexican adults.
  
  
  METHODS
  Data were obtained from two separate waves of the Mexican Health Worker Cohort Study: Wave 1 (2004-2006) and Wave 2 (2011-2013). Unconditional logistic regression models were employed to determine the cross-sectional and longitudinal association between these risk factors and elevated ALT levels.
  
  
  RESULTS
  The prevalence of elevated ALT was significantly higher among men, individuals aged under 60 years, those who were overweight or obese, diabetic, with MS or heavy/binge drinkers. The longitudinal results indicated that weight gain between waves that resulted in a change in body mass index, along with remaining overweight or obese, were significantly associated with an increased risk of elevated ALT levels. A significantly increased risk of developing elevated ALT was also observed among those who acquired diabetes or MS from Wave 1 to Wave 2.
  
  
  CONCLUSIONS
  Weight gain and acquiring diabetes or MS are associated with a significant risk of having elevated ALT. These results, within the context of the rapid increase in global obesity rates, call urgently for programs to help to prevent chronic liver disease.
authors.affiliation: Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social, Cuernavaca, Morelos, México.|Department of Health Policy and Management, Center for Cancer Prevention and Control Research, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, California, USA.
authors.forename: Yvonne N
authors.initials: YN
authors.lastname: Flores
authors.affiliation: Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, California, USA.
authors.forename: Allyn
authors.initials: A
authors.lastname: Auslander
authors.affiliation: Department of Biostatistics, Center for Cancer Prevention and Control Research, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, California, USA.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Crespi
authors.affiliation: Department of Family Medicine, David Geffen School of Medicine, UCLA, Los Angeles, California, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Rodriguez
authors.affiliation: Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, California, USA.
authors.forename: Zuo-Feng
authors.initials: ZF
authors.lastname: Zhang
authors.affiliation: Department of Digestive Diseases, David Geffen School of Medicine and Pfleger Liver Institute, UCLA, Los Angeles, California, USA.
authors.forename: Francisco
authors.initials: F
authors.lastname: Durazo
authors.affiliation: Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social, Cuernavaca, Morelos, México.|Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico.
authors.forename: Jorge
authors.initials: J
authors.lastname: Salmerón
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D000428:Alcohol Drinking; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002908:Chronic Disease; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000201:enzymology*; D005260:Female; D006282:Health Personnel; D006801:Humans; D008107:Liver Diseases / Q000150:complications / Q000201:enzymology* / Q000209:etiology; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications / Q000201:enzymology*; D008800:Mexico; D008875:Middle Aged; D009765:Obesity / Q000150:complications / Q000201:enzymology*; D012044:Regression Analysis; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D000410:Alanine Transaminase
keywords: Mexico; diabetes; liver diseases; metabolic syndrome; obesity