Relationship between Elevated Serum Alanine Aminotransferase Concentration and Metabolic Syndrome in Korean Adults

Ji Hye Kim

doi:10.4163/kjn.2009.42.8.732

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Kim: Relationship between Elevated Serum Alanine Aminotransferase Concentration and Metabolic Syndrome in Korean Adults

Original Article

Korean Journal of Nutrition

Korean Journal of Nutrition 2009; 42(8): 732-739.

Published online: 31 December 2009

DOI: https://doi.org/10.4163/kjn.2009.42.8.732

Relationship between Elevated Serum Alanine Aminotransferase Concentration and Metabolic Syndrome in Korean Adults

Ji Hye Kim

Department of Food and Nutrition, Daegu University, Gyeongbuk 712-714, Korea.

To whom correspondence should be addressed. (kjhye76@daegu.ac.kr)

Received 12 November 2009 Revised 11 December 2009 Accepted 12 December 2009

Abstract

Metabolic syndrome has been strongly associated with elevated alanine aminotransferase (ALT), a surrogate of nonalcoholic fatty liver disease. We investigated the relationship between metabolic syndrome and elevated ALT in the general Korean population. The study sample was comprised of 4,781 Korean adults who had participated in the 2005 Korean National Health and Nutrition Examination Survey. Metabolic syndrome was defined by National Cholesterol Education Program for Adult Treatment Panel III. Elevated ALT was defined as an enzyme activity > 40 IU/L for men, and > 31 IU/L for women. ALT was measured by enzymatic methods. Among participants, 425 (8.9%) subjects displayed elevated ALT. The odds ratios (ORs) for elevated ALT increased in subjects with obesity or one of components of metabolic syndrome such as abdominal obesity, high blood pressure, high fasting glucose, high triglyceride, and low HDL cholesterol after adjusting for age and sex. The unadjusted OR for elevated ALT increased according to the number of components of metabolic syndrome (OR = 1.5, 95% CI: 0.96-2.32 for 1 component; OR = 3.0, 95% CI: 1.98-4.61 for 2 components; OR = 6.3, 95% CI: 4.29-9.35 for ≥ 3 components; p for trend < 0.0001). This trend did not differ after adjustments for putative risk factors including age, sex, BMI, smoking status, and alcohol intake. Metabolic syndrome is implicated as a strong risk factor of elevated ALT in Korean adults.

Keywords: metabolic syndrome, alanine aminotransferase, nonalcoholic fatty liver disease, Korean adults

Figures and Tables

Table 1

Characteristics of study population

1, 2)All values are mean ± SD or n (%). Calculated using a χ² test or Student's t-test

BMI: Body mass index, WC: waist circumference, ALT: alanine aminotransferase, FPG: fasting plasma glucose, TG: triglyceride, HDL-C: high density lipoprotein cholesterol, SBP: systolic blood pressure, DBP: diastolic blood pressure

Table 2

Characteristics of subjects by the presence of elevated ALT in men

1, 2) All values are mean ± SD or n (%). Calculated using a χ² test or Student's t-test

Table 3

Characteristics of subjects by the presence of elevated ALT in women

1, 2) All values are mean ± SD or n (%). Calculated using a χ² test or Student's t-test

Table 4

Odds ratios (ORs) and 95% confidence intervals (CIs) for elevated ALT according to the presence of each components of metabolic syndrome among Korean adults

1) adjusted for age and sex 2) include antihypertensive medication 3) include hypoglycemic agent or insulin administration

BMI: Body mass index, WC: waist circumference, FPG: fasting plasma glucose, TG: triglyceride, HDL-C: high density lipoprotein cholesterol, SBP: systolic blood pressure, DBP: diastolic blood pressure

Table 5

Odds ratio and 95% CI for elevated ALT according to the number of components of metabolic syndrome (MS) among Korean adults

1) Model 1: adjusted for age, sex, and BMI

2) Model 2: adjusted for age, sex, BMI, smoking status, and alcohol intake

Notes

This research was supported by grants from the Daegu University grant 2008.

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