Clinical Gastroenterology, Eguchi Hospital, Saga, Japan; Department of Internal Medicine, Saga Medical School, Saga, Japan.
Hepatol Res. 2014 Nov;44(12):1196-207. doi: 10.1111/hepr.12293. Epub 2014 Feb 17.
Serum alanine aminotransferase (ALT) is important for screening, diagnosis and management of chronic liver diseases. The incidence of non-alcoholic fatty liver disease (NAFLD)/non-alcoholic steatohepatitis (NASH), which is considered a hepatic manifestation of lifestyle-related diseases, is increasing worldwide. However, the upper limit of the normal ALT level has not yet been established because of not excluding many lifestyle-related diseases. The aim of this study was to evaluate the upper limit of normal serum ALT levels in Japanese subjects.
We analyzed the serum ALT levels of 11 404 Japanese subjects negative for hepatitis B surface antigen and hepatitis C virus antibody, and who received health check-ups. Lifestyle factors related to ALT levels were determined by multivariate analysis. Subjects with all factors identified by multivariate analysis within the normal range were defined as "healthy" subjects. The 90th percentile of ALT levels in healthy subjects was defined as the upper limit of normal ALT.
Whereas alcohol intake was not a significant factor, the following were independently associated with ALT concentration by multivariate analysis: sex; age; body mass index; waist circumference; concentrations of total cholesterol, high-density lipoprotein cholesterol, triglycerides and fasting blood glucose; and fatty liver on ultrasonography. Healthy subjects consisted of 1462 (21.2%) men and 2046 (45.4%) women, and the 90th percentiles of the ALT levels in the two groups were 29 and 23 IU/L, respectively.
The upper limits of normal ALT when considering lifestyle factors in Japanese subjects were 29 IU/L in men and 23 IU/L in women.
血清丙氨酸氨基转移酶（ALT）对于慢性肝病的筛查、诊断和治疗至关重要。非酒精性脂肪性肝病（NAFLD）/非酒精性脂肪性肝炎（NASH）的发病率正在全球范围内上升，被认为是与生活方式相关疾病的一种肝脏表现。然而，由于不能排除许多与生活方式相关的疾病，正常 ALT 水平的上限尚未确定。本研究旨在评估日本人群中正常血清 ALT 水平的上限。
我们分析了 11404 名乙型肝炎表面抗原和丙型肝炎病毒抗体阴性、接受健康检查的日本受试者的血清 ALT 水平。通过多变量分析确定与 ALT 水平相关的生活方式因素。通过多变量分析确定所有因素均在正常范围内的受试者被定义为“健康”受试者。健康受试者的 ALT 水平第 90 百分位数定义为正常 ALT 的上限。
尽管饮酒不是一个显著因素，但通过多变量分析，以下因素与 ALT 浓度独立相关：性别；年龄；体重指数；腰围；总胆固醇、高密度脂蛋白胆固醇、甘油三酯和空腹血糖浓度；以及超声检查的脂肪肝。健康受试者包括 1462 名男性（21.2%）和 2046 名女性（45.4%），两组的 ALT 水平第 90 百分位数分别为 29 和 23IU/L。
考虑到日本人群的生活方式因素，正常 ALT 的上限为男性 29IU/L，女性 23IU/L。
