title: Prevalence of elevated alanine transaminase in Australia and its relationship to metabolic risk factors: A cross-sectional study of 9,447 people.
abstract: OBJECTIVE
  Elevated alanine transaminase (ALT) is a strong predictor of metabolic syndrome, but there are few data from the Australian population. We aimed to determine the prevalence of elevated ALT and association with metabolic risk factors.
  
  
  METHODS
  In this cross-sectional study including adult participants (N = 9,447) from a nationwide, population-based survey, we assessed the prevalence of elevated ALT [defined as ≥ 40 IU/L (men) and ≥ 30 IU/L (women) as baseline, and ALT as ≥ 30 IU/L (men) and ≥ 19 IU/L (women) as lower threshold], distribution of metabolic risk factors, and independent predictors of elevated ALT in logistic regression models. Analyses were weighted to the population with population weights.
  
  
  RESULTS
  Elevated ALT levels were found in 11.2% of the Australian population. People with elevated ALT were younger (43 vs 46 yrs) with more truncal adiposity (100 vs 91 cm), higher pro-atherogenic lipids and glucose and exercised less (120 vs 160 min per week, P < 0.05 for all analyses). Regression analyses indicated that younger age, male sex, diabetes, triglycerides, apolipoprotein B, and waist circumference were independent predictors of elevated ALT. The population attributable fraction of elevated ALT due to truncal obesity was estimated at 47%.
  
  
  CONCLUSIONS
  These data demonstrate a high prevalence of elevated ALT in the general population that is closely associated with metabolic risk factors. Individuals with elevated ALT should be evaluated for co-existent metabolic disorders.
authors.affiliation: School of Public Health, University of Sydney, Sydney, New South Wales, Australia.|Storr Liver Centre, Westmead Millennium Institute for Medical Research and Westmead Hospital, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Suzanne E
authors.identifier: http://orcid.org/0000-0002-6788-2250
authors.initials: SE
authors.lastname: Mahady
authors.affiliation: Charles Perkins Centre , School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Joanne
authors.initials: J
authors.lastname: Gale
authors.affiliation: School of Public Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Petra
authors.identifier: http://orcid.org/0000-0001-5879-6193
authors.initials: P
authors.lastname: Macaskill
authors.affiliation: School of Public Health, University of Sydney, Sydney, New South Wales, Australia.|Centre for Kidney Research, Children's Hospital at Westmead, Sydney, New South Wales, Australia.
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Craig
authors.affiliation: Storr Liver Centre, Westmead Millennium Institute for Medical Research and Westmead Hospital, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Jacob
authors.initials: J
authors.lastname: George
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood*; D001315:Australia / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000453:epidemiology*; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors
chemical_list: D000410:Alanine Transaminase
keywords: ALT; cross-sectional study; metabolic syndrome; population