INFLUENCE OF GENDER, BMI, AND ETHNICITY ON SERUM ALT LEVELS OF HEALTHY STUDENTS OF A MEDICAL SCHOOL
AbstractBackground: Alanine Aminotransferase (ALT) is an enzyme found in Liver and indicates injuryto Hepatocytes. It is influenced by various factors. The objectives of this study were to identify thecorrelates of ALT activity among healthy medical students of Army Medical College, NationalUniversity of Sciences and Technology, aged 18–22 years. This was to establish the mean ALTlevels of the students and compare them with those in various parts of the world and observevarious correlations that exist and factors that may influence ALT levels. Methods: Thispopulation included 143 volunteer students (93 men and 50 women) selected on the basis ofnegative answers to a detailed medical questionnaire including past medical history, drug andalcohol consumption, on the absence of clinical signs of liver disease, on the negativity ofserological testing for Hepatitis B and C virus. Results: The mean ALT level of the entirepopulation was 28.7 IU/L. A major sex-difference in ALT value was observed, the mean ALTvalue being higher in men than in women (32.1±21.7 vs. 22.6±9.7 IU/L, p<0.004). According toWHO criteria for Asians, normal BMI was taken from 18.5–23.0 Kg/m2. There was a positivesignificant correlation between serum ALT level and BMI (p<0.002). ALT level stronglycorrelates with body mass index and gender. There was no significant variation in ALT levelsamong Punjabis and Sindhis, Balochis, Pathans, and Kashmiris. Conclusion: We suggest the needof taking into account these parameters in a clinical interpretation of ALT level.Keywords: ALT, Body Mass Index, BMI
Nomura F, Ohnishi K, Satomura Y, Ohtsuki T, Fukunaga K,
Honda M, et al. Liver function in moderate obesity: study in 534
moderately obese subjects among 4613 male company
employees. Int J Obes 1986;10:349–54.
Wright C, Rivera JC, Baetz JH. Liver function testing in a
working population: three strategies to reduce false-positive
results. J Occup Med 1988;30:693–7.
Salvaggio A, Periti M, Miano L, Tavanelli M, Marzorati D. Body
mass index and liver enzyme activity in serum. Clin Chem
Bums CJ, Boswell JM, Olsen GW. Liver enzyme activity and
body mass index. J Occup Environ Med 1996;38:1248–52.
Kim HC, Nam CM, Jee SH, Han KH, Oh DK, Suh I. Normal
serum aminotransferase concentration and risk of mortality from
liver diseases: prospective cohort study. Br Med J 2004;328:983–7.
Hetland G, Holme I, Stromme JH. Co-variation of alanine
aminotransferase levels with relative weight in blood donors.
Scand J Clin Lab Invest 1992;52:51–5.
Wejstal R, Hansson G, Lindholm A, Norkrans G. Persistent
alanine aminotransferase elevation in healthy Swedish blood
donors –mainly caused by obesity. Vox Sang 1988;55:152–6.
Bizzaro N, Tremolada F, Casarin C, Bonetti P, Noventa F,
Diodati G, et al. Serum alanine aminotransferase levels among
volunteer blood donors: effect of sex, alcohol intake and obesity.
Ital J Gastroenterol 1992;24:237–41.
Clement DJ, McGuire MP, Kundrotas LW, Andrzejewski A.
Elevated serum alanine aminotransferase (ALT) associated with
muscle injury/exercise in a healthy young blood donor
population. Am J Gastroenterol 1992;87:A1297.
Moss DW, Henderson AR, Kachmar JF. Enzymes. In: Tietz NW,
ed. Textbook of Clinical Chemistry. Philadelphia: Saunders
Co;1986. p. 619–762.
Nakamura K, Motohashi Y, Kikuchi S, Tananka M, Nakano S.
Liver Transferase Activity in healthy Japanese employees aged
-39 Years. Ind Health 1998;36:218–22.
Choo V. WHO reassesses appropriate body-mass index for Asian
populations. Lancet 2002;360:235.
Prati D, Taioli E, Zanella A, Della Torre E, Butelli S, Del
Vecchio E, et al. Updated definitions of healthy ranges for serum
alanine aminotransferase levels. Ann Intern Med 2002;137:1–9.
Piton A, Poynard T, Imbert-Bismut F, Khalil L, Delattre J,
Pelissier E, et al. Factors associated with serum alanine
transaminase activity in healthy subjects: consequences for
the definition of normal values, for selection of blood donors, and
for patients with chronic hepatitis C. Hepatology 1998;27:1213–9.
Lavine JE, Schwimmer JB. Nonalcoholic fatty liver disease in the
pediatric population. Clin Liver Dis 2004;8:549–58.
Ruhl CE, Everhart JE. Determinants of the association of
overweight with elevated serum alanine aminotransferase activity
in the United States. Gastroenterology 2003;124:71–9.
Falck-Ytter Y, Younossi ZM, Marchesini G, McCullough AJ.
Clinical features and natural history of nonalcoholic steatosis
syndromes. Semin Liver Dis 2001;21:17–26.
Schwimmer JB, McGreal N, Deutsch R, Finegold MJ, Lavine JE.
Influence of gender, race, and ethnicity on suspected fatty liver in
obese adolescents. Pediatrics 2005;115:e561–5.