Moon Chang Mo, Yun Kyung Eun, Ryu Seungho, Chang Yoosoo, Park Dong Il
Department of Internal Medicine, School of Medicine, Ewha Womans University, Seoul, Korea.
Health Screening Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
J Gastroenterol Hepatol. 2017 Jul;32(7):1310-1317. doi: 10.1111/jgh.13684.
An elevated alanine aminotransferase (ALT) is frequently observed in subjects with metabolic syndrome, which is associated with the risk of colorectal adenoma (CRA). However, the relationship between ALT and CRA remains unclear. Therefore, we aimed to investigate whether high serum ALT is associated with the risk of CRA in a metabolically healthy population.
We conducted this cross-sectional study in 27,717 asymptomatic Korean adults who underwent a health checkup. Subjects were categorized as adenoma-free, hyperplastic polyp, low-risk adenoma, or high-risk adenoma. High-risk adenoma was defined as three or more adenomas, any adenoma ≥ 10 mm, or adenoma with high-grade dysplasia or villous features.
Among all participants, 10.3% and 1.5% of cases were categorized as low-risk and high-risk adenoma, respectively. In multivariate analyses adjusting for age, sex, body mass index, smoking habits, alcohol intake, regular exercise, aspirin and analgesics use, family history of colon cancer, education level, fatty liver, high-sensitivity C reactive protein, homeostasis model assessment of insulin resistance, total cholesterol, and triglyceride, an increase in ALT was positively associated with the prevalence of low-risk and high-risk adenoma (P for trend = 0.029 and 0.027, respectively). The highest quartile group of ALT level showed a significantly increased prevalence in low-risk (odds ratio, 1.17) and high-risk adenoma (odds ratio, 1.48) groups compared with the lowest quartile group. This phenomenon persisted in the subgroup analysis in men, but not in women.
In the asymptomatic healthy population, high serum ALT is significantly associated with the risk of CRA.
丙氨酸氨基转移酶（ALT）升高在代谢综合征患者中较为常见，这与结直肠腺瘤（CRA）的风险相关。然而，ALT与CRA之间的关系仍不明确。因此，我们旨在研究在代谢健康人群中，高血清ALT是否与CRA风险相关。
我们对27717名接受健康体检的无症状韩国成年人进行了这项横断面研究。受试者被分为无腺瘤、增生性息肉、低风险腺瘤或高风险腺瘤。高风险腺瘤定义为三个或更多腺瘤、任何直径≥10mm的腺瘤、或具有高级别异型增生或绒毛状特征的腺瘤。
在所有参与者中，分别有10.3%和1.5%的病例被分类为低风险和高风险腺瘤。在对年龄、性别、体重指数、吸烟习惯、饮酒量、规律运动、阿司匹林和镇痛药使用、结肠癌家族史、教育水平、脂肪肝、高敏C反应蛋白、胰岛素抵抗的稳态模型评估、总胆固醇和甘油三酯进行校正的多变量分析中，ALT升高与低风险和高风险腺瘤的患病率呈正相关（趋势P值分别为0.029和0.027）。与最低四分位数组相比，ALT水平最高的四分位数组在低风险（优势比，1.17）和高风险腺瘤（优势比，1.48）组中的患病率显著增加。这种现象在男性亚组分析中持续存在，但在女性中不存在。
在无症状健康人群中，高血清ALT与CRA风险显著相关。
