Kabir Ali, Pourshams Akram, Khoshnia Masoud, Malekzadeh Fatemeh
Department of Epidemiology, Faculty of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran ; Center for Educational Research in Medical Sciences, Tehran University of Medical Sciences, Tehran, IR Iran.
Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.
Hepat Mon. 2013 Oct 20;13(10):e10640. doi: 10.5812/hepatmon.10640. eCollection 2013.
Normal or elevated values of serum alanine aminotransferase level (ALT) vary in different studies mostly related to characteristics of reference population including age, gender, body mass index, nonalcoholic fatty liver disease (NAFLD), and metabolic syndrome prevalence.
To measure upper normal limit (UNL) for serum ALT in an apparently healthy Iranian old population (which we had not sufficient data before this study), and its modulating factors.
All inhabitants (> 50 years old) of Kalaleh, Golestan, Iran (N = 1986) were invited to the study. ALT measurements were performed for all subjects using the same laboratory method. Upper limit of normal (ULN) ALT was calculated based on its 95th percentile in normal weight subjects. Modulating factors of ALT were determined by multivariate analysis.
A total of 1309 subjects, with the mean age of 61.5 ± 7.5 years were included. UNL of ALT was 18.8 U/L and 21.4 U/L in women and men, respectively. Based on univariate analysis, waist circumference (r = 0.124, P = 0.01), body mass index (r = 0.118, P = 0.01), triglyceride (r = 0.143, P = 0.01), and having metabolic syndrome (OR = 2.04) modulate ALT levels in men. Also triglyceride (r = 0.119, P = 0.01) modulates ALT levels in women.
The calculated level for UNL of ALT is considerably far lower than previous accepted value. Age, gender, ethnicity, and metabolic factors should be accounted in future studies to determine normal ALT level.
血清丙氨酸氨基转移酶水平（ALT）的正常或升高值在不同研究中有所不同，这主要与参考人群的特征有关，包括年龄、性别、体重指数、非酒精性脂肪性肝病（NAFLD）和代谢综合征患病率。
测量伊朗一个看似健康的老年人群（在本研究之前我们没有足够数据）血清ALT的正常上限（UNL）及其调节因素。
邀请了伊朗戈勒斯坦省卡拉莱赫所有年龄大于50岁的居民（N = 1986）参与研究。所有受试者均使用相同的实验室方法进行ALT测量。正常上限（ULN）ALT根据正常体重受试者的第95百分位数计算得出。通过多变量分析确定ALT的调节因素。
共纳入1309名受试者，平均年龄为61.5±7.5岁。女性和男性的ALT正常上限分别为18.8 U/L和21.4 U/L。单变量分析显示，腰围（r = 0.124，P = 0.01）、体重指数（r = 0.118，P = 0.01）、甘油三酯（r = 0.143，P = 0.01）以及患有代谢综合征（OR = 2.04）可调节男性的ALT水平。甘油三酯（r = 0.119，P = 0.01）也可调节女性的ALT水平。
计算得出的ALT正常上限水平远低于先前公认的值。未来研究在确定正常ALT水平时应考虑年龄、性别、种族和代谢因素。
