Tejos Rodrigo, Padilla Oslando, Pizarro Margarita, Solís Nancy, Arab Juan Pablo, Margozzini Paula, Miquel Juan Francisco, Riquelme Arnoldo, Arrese Marco
Departamento de Gastroenterología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile,
Departamento de Salud Pública, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.
Rev Med Chil. 2013 Jul;141(7):909-16. doi: 10.4067/S0034-98872013000700011.
Determination of Alanine aminotransferase serum levels ([ALT]s) is a sensitive ana reliable test for liver diseases.
To report the prevalence of abnormal [ALT]s in Chilean population and to identify associated variables.
We analyzed data from a random sub-sample of 2,794 adults surveyed during the second Chilean National Health Survey. Abnormal [ALT]s were defined by using three different cut-off values (COV), two fixed COV (COV1: > 30 IU/L in men and > 19 IU/L in women and COV2 pre-defined by the performing laboratory) and a COV adjusted by age, weight and sex (COV3 > 31 IU/L for women and > 44 IU/L and men > 42 IU/L and > 66 IU/L with a BMI > 23). Logistic regression analysis was performed to determine risk factors for elevated [ALT]s.
Mean [ALT]s values were 30.14 I U/L in men and 22.03 IU/L in women. The observed prevalence of abnormal [ALT]s defined by different COV were 38%, 11.5%, and 8.1% for COV1, COV2 and COV3 respectively. Variables independently associated to abnormal [ALT]s in a multivariate analysis were the following: serum gamma-glutamyl-transpeptidase (OR: 1.055 [95% CI 1.033-1.078]) and body mass index (OR:1.13 [95% CI 1.09-1.17]). Variables inversely associated with abnormal [ALT]s (COV1) were mole gender (OR-.0.976 [95% CI 0.96-0.99) and HDL-cholesterol (OR:0979 [95% CI 0.96-0.99]).
Independently of the COV used, Chilean population exhibits a high prevalence of abnormal [ALT]s which may reflect a significant burden of liver disease. Non-alcoholic fatty liver disease could be a major contributor to elevated [ALT]s considering the association of abnormal [ALT]s and metabolic variables.
血清丙氨酸氨基转移酶水平（[ALT]s）的测定是一种用于诊断肝脏疾病的敏感且可靠的检测方法。
报告智利人群中[ALT]s异常的患病率，并确定相关变量。
我们分析了智利第二次全国健康调查中随机抽取的2794名成年人的子样本数据。使用三种不同的临界值（COV）定义[ALT]s异常，两种固定临界值（COV1：男性>30 IU/L，女性>19 IU/L；COV2由执行检测的实验室预先定义）以及一种根据年龄、体重和性别调整的临界值（COV3：女性>31 IU/L，男性>44 IU/L，BMI>23时男性>42 IU/L且>66 IU/L）。进行逻辑回归分析以确定[ALT]s升高的危险因素。
男性的平均[ALT]s值为30.14 IU/L，女性为22.03 IU/L。根据不同临界值定义的[ALT]s异常的观察患病率，COV1为38%，COV2为11.5%，COV3为8.1%。多变量分析中与[ALT]s异常独立相关的变量如下：血清γ-谷氨酰转肽酶（OR：1.055 [95%CI 1.033 - 1.078]）和体重指数（OR：1.13 [95%CI 1.09 - 1.17]）。与[ALT]s异常（COV1）呈负相关的变量为性别（OR：0.976 [95%CI 0.96 - 0.99]）和高密度脂蛋白胆固醇（OR：0.979 [95%CI 0.96 - 0.99]）。
无论使用何种临界值，智利人群中[ALT]s异常的患病率都很高，这可能反映了肝脏疾病的重大负担。考虑到[ALT]s异常与代谢变量的关联，非酒精性脂肪性肝病可能是[ALT]s升高的主要原因。
