Clinical disparity of elevated serum alanine aminotransferase (ALT) levels among the working population of Taipei, Taiwan

Abstract

Purpose: To explore sex variations in the prevalence and factors of high serum alanine aminotransferase (ALT) level among the working population in Taipei, Taiwan.Methods: This study included 8,351 healthy adults (5,247 men and 3,104 women) who admitted to a teaching hospital voluntarily for a physical examination in 2009. The definitions of occupations include computer and mathematical occupations, architecture and engineering occupations, community and social service occupations, sales and related occupations, office and administrative support occupations, and production occupations. The age distribution of $\leq$ 29 yrs, 30-39 yrs, 40-49 yrs, and $\geq$ 50 yrs were 22.5\%, 36.8\%, 23.5\%, and 17.2\%, respectively. Fasting blood samples were drawn using venipuncture and participants were interviewed with a structured questionnaire.Results: The overall prevalence of high serum ALT level ($\geq $ 40 U/L) was 17.1\%. After stratified the data according to age into four age groups ($\leq$ 29yrs, 30-39 yrs, 40-49 yrs, and $\geq$ 50 yrs) , the men participants revealed a higher prevalence of high serum ALT levels for all age groups than the women participants. Bases on multiple logistic regression models, for the men, the significant factors were associated with high serum ALT level and included age (OR = 0.96, 95\% CI: 0.95-097), BMI [no matter whether overweight (OR = 2.45, 95\% CI: 1.99-3.02) or obese (OR = 4.02, 95\% CI: 3.22-5.03)], hypercholesterolemia (yes vs. no, OR = 1.25, 95\% CI: 1.05-1.48), hypertriglyceridemia (OR = 1.25, 95\% CI: 1.04-1.50), high FPG levels (OR = 1.48, 95\% CI: 1.05-2.09), high AST levels (OR = 26.71, 95\% CI: 19.00-37.54), hyperuricemia (OR = 1.48, 95\% CI: 1.25-1.76), high ALP levels (OR = 1.20, 95\% CI: 1.00-1.45), and high glutamic acid transaminase levels (OR = 4.31, 95\% CI: 3.61-5.14). For the women subjects, the statistically significant factors that were associated with high serum ALT level included BMI [no matter whether overweight (OR = 3.53, 95\% CI: 1.87-6.67) or obese (OR = 4.32, 95\% CI: 2.26-8.23)], high AST levels (yes vs. no, OR = 38.49, 95\% CI: 21.45-49.28), high BUN levels (yes vs. no, OR = 1.66, 95\% CI: 1.03-2.29), and high glutamic acid transaminase levels (yes vs. no, OR = 9.87, 95\% CI: 5.79-16.83).Conclusion: In conclusion, the clinical problem of elevated serum ALT level is important in the working population. Many subjects are asymptomatic and the diagnosis of high serum ALT level should be considered with sex, age, hyperuricemia, high AST levels, high ALP levels, high glutamic acid transaminase levels, and metabolic risk factors in mind.