Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA.
Scand J Clin Lab Invest. 2012 May;72(3):258-64. doi: 10.3109/00365513.2012.660536.
Serum alanine aminotransferase (ALT) activity is a widely-used surrogate marker for liver injury. However, mild elevation of serum ALT is frequently observed in apparently healthy individuals, making it sometimes challenging to interpret whether this laboratory abnormality is medically benign or serious. To obtain a better understanding of the factors influencing ALT levels, we examined the relation between ALT and a number of anthropometric and biochemistry measurements in humans.
We assessed the associations of ALT with hematocrit (HCT) in 1,200 apparently healthy adults from an Amish population. Multivariate analyses were carried out to determine whether observed associations were independent of other factors known to modulate ALT and HCT, including body mass index (BMI) and sex. The correlation detected in the Amish was then replicated in an independent population sample (N = 9,842) from the National Health and Nutrition Examination Survey (NHANES) III.
ALT levels were positively correlated with HCT (r = 0.33, p < 0.0001) in both Amish and NHANES III. The magnitude of association was unchanged after adjustment for BMI, but was reduced by age/sex adjustment to r = 0.18 (p < 0.0001) and r = 0.17 (p < 0.0001) in the Amish and NHANES populations, respectively. HCT accounts for about 3% of the population variation in ALT, which is smaller than the contributions of gender and BMI, but larger than individual blood pressure and cholesterol components.
We observed a correlation between ALT and HCT, suggesting that HCT may be a newly identified modulator of ALT in humans.
血清丙氨酸氨基转移酶(ALT)活性是一种广泛用于肝损伤的替代标志物。然而,在明显健康的个体中,血清 ALT 的轻度升高经常观察到,这使得有时难以解释这种实验室异常是良性还是严重的。为了更好地了解影响 ALT 水平的因素,我们检查了 ALT 与许多人体测量学和生物化学测量值之间的关系。
我们评估了 ALT 与来自阿米什人群的 1200 名明显健康成年人的血细胞比容(HCT)之间的关联。进行了多变量分析,以确定观察到的关联是否独立于其他已知调节 ALT 和 HCT 的因素,包括体重指数(BMI)和性别。然后在来自国家健康和营养检查调查(NHANES)III 的独立人群样本(N = 9842)中复制了在阿米什人中检测到的相关性。
ALT 水平与 HCT 在阿米什人和 NHANES III 中均呈正相关(r = 0.33,p <0.0001)。调整 BMI 后,关联的幅度保持不变,但通过年龄/性别调整,在阿米什人和 NHANES 人群中分别降至 r = 0.18(p <0.0001)和 r = 0.17(p <0.0001)。HCT 占 ALT 人群变异的约 3%,这小于性别和 BMI 的贡献,但大于单个血压和胆固醇成分的贡献。
我们观察到 ALT 与 HCT 之间存在相关性,这表明 HCT 可能是人类 ALT 的新鉴定调节剂。