Kumar Satish, Amarapurkar Anjali, Amarapurkar Deepak
Department of Pathology, BYL Nair Ch Hospital & TN Medical College, Mumbai, India.
Indian J Med Res. 2013 Dec;138(6):894-9.
BACKGROUND & OBJECTIVES: Serum alanine aminotransferase (ALT) level is most commonly used as a marker for the assessment of various liver diseases. Currently upper limits of normal for aspartate aminotransferase (AST) or ALT levels used are based on the western literature. This study was conducted to determine the ALT and AST levels in healthy blood donors from western India and to determine the relation with body mass index (BMI) and waist-to-hip ratio (WHR).
A total of 5077 voluntary blood donors were selected with strict routine inclusion and exclusion criteria. Weight, height, BMI and WHR were determined along with AST and ALT levels. BMI and WHR were correlated with liver enzymes.
Of the 5077 donors, 160 were excluded due to positive serological results. In the remaining 4917 individuals, 4643 (94.4%) were males and 274 (5.6%) were females. Majority 3024 (61.5%) showed BMI more than 23 kg/m2. WHR > 0.85 and 0.80 was found in 4046 (87.0%) males and 250 (91.2%) females. Mean AST and ALT levels in males were 23.4 ± 9.9 IU/l and 27.0 ± 17.3 IU/l and in females 19.1 ± 9.8 IU/l and 17.7 ± 11.2 IU/l, respectively. With increase in BMI, there was a significant increase in AST and ALT levels. Similar increase was also seen with WHR.
INTERPRETATION & CONCLUSIONS: Majority of voluntary blood donors showed high BMI and WHR which was directly related to AST and ALT levels. This study highlights the magnitude of obesity in general healthy population of western India and a need to revise the current normal limits of serum ALT.
血清丙氨酸氨基转移酶(ALT)水平是评估各种肝脏疾病最常用的指标。目前使用的天冬氨酸氨基转移酶(AST)或ALT水平的正常上限是基于西方文献。本研究旨在确定印度西部健康献血者的ALT和AST水平,并确定其与体重指数(BMI)和腰臀比(WHR)的关系。
共选取5077名自愿献血者,采用严格的常规纳入和排除标准。测定体重、身高、BMI和WHR以及AST和ALT水平。将BMI和WHR与肝酶进行相关性分析。
5077名献血者中,160名因血清学结果阳性被排除。在其余4917名个体中,男性4643名(94.4%),女性274名(5.6%)。大多数3024名(61.5%)的BMI超过23kg/m²。4046名(87.0%)男性和250名(91.2%)女性的WHR>0.85和0.80。男性的平均AST和ALT水平分别为23.4±9.9IU/L和27.0±17.3IU/L,女性分别为19.1±9.8IU/L和17.7±11.2IU/L。随着BMI的增加,AST和ALT水平显著升高。WHR增加时也观察到类似的升高。
大多数自愿献血者的BMI和WHR较高,这与AST和ALT水平直接相关。本研究突出了印度西部一般健康人群中的肥胖程度,以及修订当前血清ALT正常上限的必要性。