Claus Matthias, Antoni Christoph, Hofmann Bernd
Corporate Health Management, ESG/CS - H308, BASF SE, 67056, Ludwigshafen am Rhein, Germany.
Department of Medicine II, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, 68167, Mannheim, Germany.
BMC Gastroenterol. 2021 Jan 9;21(1):25. doi: 10.1186/s12876-021-01601-2.
We aimed to determine the prevalence of elevated alanine aminotransferase (eALT) in employees of a German chemical company, and analyze its association with sociodemographic, work- and lifestyle-related factors.
The cross-sectional study is based on data surveyed from occupational health check-ups between 2013 and 2018 at the site clinic of a chemical company based in Ludwigshafen, Germany. We used logistic regression analyses to assess the association between sociodemographic, work- and lifestyle-related characteristics and eALT. Quantile regression technique was applied to investigate if associations vary across different quantiles of the ALT distribution.
Participants (n = 15,348) were predominantly male (78.3%) with a mean age of 42.2 years (SD 10.7). The prevalence of eALT was 18.5% (21.6% in men/7.2% in women) with a geometric mean of 28.9 U/L (32.8 U/L in men/18.5 U/L in women). In the multivariable logistic regression model, odds of eALT were significantly higher for males (OR 2.61; 95%-CI 2.24-3.05), manual workers (OR 1.23; 95%-CI 1.06-1.43), overweight (OR 2.66; 95%-CI 2.36-3.00) or obese respondents (e.g. OR 7.88; 95%-CI 5.75-10.80 for obesity class III), employees who consume any number of alcoholic drinks/week (e.g. OR 1.32; 95%-CI 1.16-1.49 for ≥ 3 drinks per week) and diabetics (OR 1.47; 95%-CI 1.22-1.78). Additionally, season of participation was significantly associated with eALT, with odds being higher for participation in spring, fall or winter, as compared to summer. A significant interaction between age and gender (p < 0.001) was found, showing approximately a u-shaped age/ALT relationship in women and an inversely u-shaped relationship in men. Quantile regression showed an increasing positive effect of male gender, overweight/obesity, and for diabetics on ALT level when moving from the lowest (q0.1) to the highest (q0.9) considered quantile. Additionally, from the lowest to the highest quantile an increasing negative effect on ALT for older age was observed.
Prevalence of eALT in our sample of employees can be considered as high, with almost one in five participants affected. Identification of risk groups allows the implementation of targeted preventive measures in order to avoid transition to severe morbidity.
我们旨在确定一家德国化工公司员工中丙氨酸氨基转移酶升高（eALT）的患病率，并分析其与社会人口统计学、工作和生活方式相关因素的关联。
这项横断面研究基于2013年至2018年在德国路德维希港一家化工公司现场诊所进行的职业健康检查所调查的数据。我们使用逻辑回归分析来评估社会人口统计学、工作和生活方式相关特征与eALT之间的关联。应用分位数回归技术来研究这些关联在ALT分布的不同分位数之间是否存在差异。
参与者（n = 15348）以男性为主（78.3%），平均年龄为42.2岁（标准差10.7）。eALT的患病率为18.5%（男性为21.6%/女性为7.2%），几何平均数为28.9 U/L（男性为32.8 U/L/女性为18.5 U/L）。在多变量逻辑回归模型中，男性（比值比2.61；95%置信区间2.24 - 3.05）、体力劳动者（比值比1.23；95%置信区间1.06 - 1.43）、超重（比值比2.66；95%置信区间2.36 - 3.00）或肥胖受访者（例如，III级肥胖的比值比为7.88；95%置信区间5.75 - 10.80）、每周饮用任何数量酒精饮料的员工（例如，每周≥3杯的比值比为1.32；95%置信区间1.16 - 1.49）以及糖尿病患者（比值比1.47；95%置信区间1.22 - 1.78）的eALT比值显著更高。此外，参与调查的季节与eALT显著相关，与夏季相比，春季、秋季或冬季参与调查时的比值更高。发现年龄和性别之间存在显著交互作用（p < 0.001），表明女性中年龄/ALT关系大致呈U形，男性中呈倒U形。分位数回归显示，从最低（q0.1）到最高（q0.9）考虑的分位数，男性、超重/肥胖以及糖尿病对ALT水平的正向影响逐渐增加。此外，从最低到最高分位数，年龄对ALT的负向影响逐渐增加。
我们样本中员工的eALT患病率可被视为较高，近五分之一的参与者受到影响。识别风险群体有助于实施有针对性的预防措施，以避免病情发展为严重疾病。
