Distribution Of Alanine Aminotransferase Research Articles

Prevalence and Risk Factors of Advanced Liver Fibrosis in a Population-Based Study in Germany.

The prevalence of liver disease, and especially of advanced liver fibrosis, in the German population is poorly defined. The aim of the study was to explore liver enzymes and surrogate scores of hepatic steatosis and advanced hepatic fibrosis in a population‐based cohort study in Germany. In the cross‐sectional population‐based Gutenberg Health study, data of 14,950 participants enrolled between 2007 and 2012 were captured and analyzed. The distribution of alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma‐glutamyltransferase (GGT), fatty liver index (FLI), and Fibrosis‐4 (FIB‐4) score, as well as the underlying risk factors, were assessed by regression models. Elevated liver enzymes in this population‐based sample were seen in 19.9% for ALT, 12.8% for AST, and 14% for GGT. Risk factors for liver disease included alcohol use and the presence of the metabolic syndrome, which were both risk factors associated with increased liver enzymes. The FLI suggested that 37.5% of the population exhibited hepatic steatosis and 1.1% of patients exhibited a FIB‐4 above the upper cutoff, while 19.2% were in the intermediate range. Interestingly, advanced fibrosis was significantly more frequent in men compared with women (FIB‐4: 1.5% vs. 0.6% [P < 0.0001]; NFS: 3.6% vs. 1.9% [P < 0.0001]). In addition, age was a relevant risk factor for exhibiting a noninvasive surrogate score suggestive of advanced fibrosis in the current study population. Conclusion: Elevated liver enzymes were seen in almost a fifth of the German population. At the population‐based level, the prevalence of advanced fibrosis was estimated at 1% in Germany.

Under-reporting of Hepatic Steatosis in Children: A Missed Opportunity for Early Detection

To determine the prevalence of underreporting of hepatic steatosis found incidentally on computed tomography (CT). Retrospective cross-sectional study including patients <18years of age who had undergone unenhanced abdominal CT for evaluation of nephrolithiasis. Hepatic and splenic attenuation were measured independently by 2 reviewers. Hepatic steatosis was defined using various previously established criteria (4 original criteria designed to detect moderate/severe steatosis and 3 secondary criteria designed to identify mild steatosis). Radiology reports and clinical notes were reviewed for documentation of steatosis. Serum alanine aminotransferase levels were collected. Kappa statistics were used to assess agreement between reviewers. A total of 584 patients were included. Agreement between reviewers' measurements for categorical classification of presence of steatosis was excellent (kappa statistic agreement >87%). The prevalence of hepatic steatosis ranged from 3% to 35%, depending on the criterion. Using absolute liver attenuation <48 Hounsfield units (most likely reflective of the truth, given alanine aminotransferase distribution and body mass index data), the prevalence was 7% (n=42). Steatosis was reported for only 12 of 42 (28%) of these patients and was documented in clinical notes in only 3 of those cases. Hepatic steatosis is underreported as an incidental finding of CT for nephrolithiasis. Given the prevalence and silent nature of nonalcoholic fatty liver disease, a high level of suspicion is needed, so as not to miss the opportunity to identify steatosis in childhood.

Subcellular distribution of alanine aminotransferase activity in maize (Zea mays L.) leaves

The intracellular distribution of alanine aminotransferase (AlaAT, EC 2.6.1.2) activity with L-alanine and 2-oxoglutarate as a substrates in maize whole leaf extract and bundle sheath cells was studied. After isolation of the mitochondrial-peroxisomal fraction, mitochondria and peroxisomes were separated by centrifugation on a linear 40–52 % (w/w) sucrose gradient. L-Alanine-2-oxoglutarate transaminating activity of whole leaf extract showed two peaks: first distinctly higher associated with mitochondria and second lower with peroxisomes. In bundle sheath cells only one peak of this activity was found. It corresponded to the mitochondrial region of the gradient. It is proposed that mitochondrial L-alanine — 2-oxoglutarate activity was brought about by AlaAT. Glycine aminotransferase (EC 2.6.1.4) could be responsible for the same activity in peroxisomes.

The distribution of serum alanine aminotransferase levels in a blood donor population.

The authors studied the distribution of alanine aminotransferase (ALT) levels in 10,034 volunteer blood donors. The mean +/- SD ALT value was 21.4 +/- 19.3 IU/liter; 549 (5.5%) of the donors had a ALT value greater that 45 IU; 2.5 per cent had ALT values greater than 60 IU. In general, ALT levels were higher in males than in females, and were age related; peak values occurred in the third decade of life for males and between 50-60 years of age in females. ALT values greater than 45 IU were found significantly more often in males, in donors of both sexes 30-40 years of age, in married donors, in non-Caucasians, and in those whose education level was no higher than high school. Follow-up samples in donors with an initial ALT greater than 45 IU, revealed that 67% continued to have ALT values above 45 IU 2-8 weeks following initial sampling, and 40% had an ALT greater than 45 IU when tested again six months after entry into the study. ALT values greater than 60 IU were associated with a significantly increased prevalence of antibody of hepatitis B surface antigen (anti-HBs) and antibody to hepatitis B core antigen (anti-HBc) occurring together. No statistically significant association was found between transaminase activity and the prevalence of anti-HBs or anti-HBc alone, or with hepatitis A antibody. These findings demonstrate that there are defined sociodemographic and serologic features of donors with elevated ALT values.