title: Longitudinal Changes in Liver Aminotransferases Predict Metabolic Syndrome in Chinese Patients with Nonviral Hepatitis.
abstract: OBJECTIVE
  This study explored the correlation of longitudinal changes in serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels with the incidence of metabolic syndrome (Mets) based on a dynamic health examination cohort.
  
  
  METHODS
  A Mets-free dynamic cohort involving 4541 participants who underwent at least three health examinations from 2006 to 2011 was included in the study. Mets was defined according to the Chinese Medical Association Diabetes Branch definition that included hypertension, obesity, hyperlipidemia, and hyperglycemia. Generalized estimating equation (GEE) model was used to analyze multivariate relative risk (RR) of repeated observations of ALT and AST in quartiles for Mets or its components according to gender.
  
  
  RESULTS
  In all, 826 Mets cases were reported. Adjustment of relevant parameters indicated that time-varying changes in ALT and AST levels were positively associated with the incidence of Mets in a dose-response manner. Positive association between high ALT levels and fatty liver was much stronger than that between high AST levels and fatty liver, particularly in male participants. These associations were consistently observed in the following subgroups: participants with ALT and AST levels of <40 U/L, participants with of <25 kg/m2, and participants with non-fatty liver. Furthermore, participants with 2 Mets components at baseline showed lower multivariate adjusted RRs of ALT and AST for Mets than participants with 0-1 Mets component.
  
  
  CONCLUSIONS
  These results suggested that elevated serum ALT and AST levels were early biomarkers of Mets or its components.
authors.affiliation: Department of Prevention and Health Care, DongyingShengli Oilfield Central Hospital, Dongying 257000, Shandong, China.
authors.forename: Qi Cai
authors.initials: QC
authors.lastname: Chen
authors.affiliation: Department of Epidemiology, School of Public Health, Shandong University, Jinan 250012, Shandong, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Xiao
authors.affiliation: Department of Epidemiology, School of Public Health, Shandong University, Jinan 250012, Shandong, China; Tianjin Entry-Exit Inspection and Quarantine Bureau, Tianjin 300000, China.
authors.forename: Peng Peng
authors.initials: PP
authors.lastname: Zhang
authors.affiliation: Department of Epidemiology, School of Public Health, Shandong University, Jinan 250012, Shandong, China; Department of Nutrition and Food Safety, Zhejiang Center for Disease Control and Prevention, Hangzhou 310051, Zhejiang, China.
authors.forename: Li Li
authors.initials: LL
authors.lastname: Chen
authors.affiliation: Department of Epidemiology, School of Public Health, Shandong University, Jinan 250012, Shandong, China.
authors.forename: Xiao Xiao
authors.initials: XX
authors.lastname: Chen
authors.affiliation: Department of Epidemiology, School of Public Health, Shandong University, Jinan 250012, Shandong, China.
authors.forename: Shu Mei
authors.initials: SM
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006505:Hepatitis / Q000150:complications* / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D015994:Incidence; D008099:Liver / Q000201:enzymology / Q000503:physiopathology; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000175:diagnosis* / Q000201:enzymology / Q000453:epidemiology; D008875:Middle Aged; D055815:Young Adult
chemical_list: D015415:Biomarkers; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase
keywords: Alanine aminotransferase; Aspartate aminotransferase; Dynamic cohort study; Generalized estimating equation model; Metabolic syndrome