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Elevated Aminotransferases Common in US

Issue: December 2015

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HONOLULU — Elevated alanine and aspartate aminotransferase serum levels have become more common in the U.S. and could be an indication of rising nonalcoholic fatty liver disease, according to a poster presented at ACG 2015.

Using data from 7,784 adults in the National Health and Nutritional Examination Survey, researchers sought to identify independent predictors of elevated aminotransferase activity since previous studies used high cut-offs for ALT, did not adjust for various sociodemographic or clinical variables and did not use a representative sample of the general population, according to the research.

Of all the adults used in this cohort, 28% had elevated alanine aminotransferase levels, 9% had elevated aspartate aminotransferase levels and 33% had elevated levels of both serums.

Dhruv Mehta

Unadjusted analyses showed that AST or ALT elevation was more common among men and Mexican Americans; patients with high BMI or waist circumference, diabetes or lower physical activity, high total cholesterol, LDL and triglyceride levels, low HDL levels or higher homeostasis model assessment of insulin resistance (HOMA-IR) scores. An adjusted multivariate regression model that included these predictors showed that high BMI (OR = 2.04; 95% CI, 1.57-2.7) and HOMA-IR scores (OR = 1.04; 95% CI, 1.02-1.06) were the most significant independent predictors of elevated aminotransferases.

“These associations did not change significantly after excluding those with current prescription medication use or those with any alcohol use,” the researchers wrote.

“This study indicates that NAFLD is on a rise and true prevalence of NAFLD may be even higher, as it can also present without elevated liver enzymes,” Dhruv Mehta, MD, New York Medical College, Westchester Medical Center, New York, told Healio.com/Hepatology. “We need more screening and preventative strategies that can help detect and reverse this epidemic of metabolic syndrome, which ultimately can lead to NAFLD.”

Reference:

Mehta D, et al. Abstract P1818. Presented at: ACG; Oct. 16-21, 2015; Honolulu.

Disclosures: The researchers report no relevant financial disclosures.