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J. Clin. Med. 2019, 8(4), 445; https://doi.org/10.3390/jcm8040445

Utility of ALT Concentration in Men and Women with Nonalcoholic Fatty Liver Disease: Cohort Study

1
Division of Cardiology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea
2
Division of Biostatistics, Department of R & D Management, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea
3
Division of Endocrinology, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA
4
Stanford Diabetes Research Center, Stanford University School of Medicine, Stanford, CA 94305, USA
*
Author to whom correspondence should be addressed.
Received: 21 February 2019 / Revised: 16 March 2019 / Accepted: 29 March 2019 / Published: 2 April 2019
(This article belongs to the Section Gastroenterology & Hepato-Pancreato-Biliary Medicine)
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Abstract

Nonalcoholic fatty liver disease (NAFLD) is the most common cause of elevated alanine aminotransferase (ALT), but the clinical utility of ALT in detecting and following individuals with NAFLD remains unclear. We conducted a retrospective analysis of 30,988 men and 5204 women with NAFLD diagnosed by ultrasound and stratified them according to sex-specific ALT quartiles. We compared metabolic variables at baseline and repeated ultrasound after at least 6 months among ALT quartiles (Q) in men (Q1 5–24, Q2 25–33, Q3 34–48, Q4 ≥ 49 IU/L) and women (Q1 5–14, Q2 15–20, Q3 21–28, Q4 ≥ 29 IU/L). Prevalence of obesity (BMI ≥ 25 kg/m2) and metabolic abnormalities (glucose intolerance, hypertension) significantly (p < 0.001) increased from ALT Q1 to Q4 in both men and women at baseline. After a mean follow-up of 4.93 years, 17.6% of men and 31.1% of women resolved their NAFLD. The odds ratio (OR) of resolving significantly (p < 0.001) decreased by quartiles even after multiple adjustments. The adjusted OR for resolution in Q4 was 0.20 (0.18–0.23) in men and 0.35 (0.26–0.47) in women compared with Q1. Individuals with NAFLD span the full range of ALT concentrations, but those with the highest ALT have the worst metabolic profile and persistent NAFLD. View Full-Text
Keywords: alanine transaminase; non-alcoholic fatty liver disease; fatty liver; insulin resistance; obesity alanine transaminase; non-alcoholic fatty liver disease; fatty liver; insulin resistance; obesity
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Sung, K.-C.; Lee, M.-Y.; Lee, J.-Y.; Lee, S.-H.; Kim, S.-H.; Kim, S.H. Utility of ALT Concentration in Men and Women with Nonalcoholic Fatty Liver Disease: Cohort Study. J. Clin. Med. 2019, 8, 445.

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