Abstract
BackgroundElevated alanine aminotransferase (ALT) levels may be associated with metabolic syndrome and cardiovascular diseases. This study aimed to investigate the association between elevated ALT levels and cardiometabolic risk factors in a rural Chinese population.MethodsThis was a cross-sectional study conducted from July 2012 to August 2013, including 11,573 subjects (5,357 men and 6,216 women) aged ≥35 years in rural areas of Liaoning Province. A physical examination was performed and metabolic indicators were examined under standard protocols. Subjects were divided into those with elevated ALT levels (>40U/L) and those with normal ALT levels (≤40U/L).ResultsParticipants with elevated ALT levels had higher levels of almost all cardiometabolic risk factors than those with normal ALT levels. In individuals with elevated ALT levels, weight, height, waist circumference, and body mass index (BMI), which are indicators for general and abdominal obesity, were significantly higher (p < 0.001) than those in individuals with normal ALT levels. There was no significant difference in race, current smoking, or physical activity between the two groups. Other cardiometabolic risk factors, such as systolic blood pressure, diastolic blood pressure, and fasting plasma glucose, TC, TG, low-density lipoprotein cholesterol, and serum uric acid levels, were higher in participants with elevated ALT levels than in those with normal ALT levels. Logistic regression analysis showed that male sex, younger age, and the presence of high TC, high TG, and low high-density lipoprotein cholesterol levels, current smoking status, BMI ≥25 kg/m2, abdominal obesity, hyperuricemia, and HtgW phenotype were significantly (p < 0.05) associated with elevated ALT levels. Sex-related differences were also investigated. For men, hypertension (OR 1.33, 95 % CI 1.08–1.62), high TC levels (OR 1.63, 95 % CI 1.23–2.17), high TG levels (OR 1.62, 95 % CI 1.25–2.09), BMI ≥25 kg/m2 (OR 1.52, 95 % CI 1.07–2.18), and hyperuricemia (OR 1.92, 95 % CI 1.52–2.40) were significantly (p < 0.05) related to elevated serum ALT levels, but this was not observed in women.ConclusionsThere are significant relationships of elevated ALT levels with cardiometabolic risk factors and several sex-related differences in rural Chinese. Elevated serum ALT levels are associated with a worse cardiac risk profile.
Highlights
Elevated alanine aminotransferase (ALT) levels may be associated with metabolic syndrome and cardiovascular diseases
Because ALT is closely related to fat accumulation in the liver [3], it is commonly considered as a surrogate marker for nonalcoholic fatty liver disease (NAFLD) in some epidemiological studies [4, 5]
Previous studies have found that elevated ALT levels are associated with obesity and metabolic syndrome, including a study performed in the Japanese population [27] and a population-based crosssectional survey in Korean adolescents [28]
Summary
Elevated alanine aminotransferase (ALT) levels may be associated with metabolic syndrome and cardiovascular diseases. This study aimed to investigate the association between elevated ALT levels and cardiometabolic risk factors in a rural Chinese population. Several studies have indicated that elevated serum ALT levels are associated with age, sex, obesity, waist circumference, fasting blood glucose levels, and serum triglyceride levels [10, 11]. Patients with cardiometabolic risk factors usually have elevated serum ALT activity, and serum ALT levels are commonly used to monitor liver function in people with metabolic disorders. The HtgW phenotype is represented by the simultaneous presence of elevated serum triglyceride levels and an increased waist circumference [13], and this phenotyope is a major determinant of cardiometabolic risk among Turks [14]
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