Department of Infectious diseases, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran.
BMJ Open Gastroenterol. 2022 May;9(1). doi: 10.1136/bmjgast-2022-000870.
Alanine aminotransferase (ALT) is a marker of hepatic damage and its range can be affected by viral hepatitis, alcoholic hepatitis and non-alcoholic fatty liver diseases. We aimed to study the factors associated with higher ALT level and update the upper limit of normal (ULN) in the Vietnamese population.
This cross-sectional study enrolled 8383 adults, aged 18 years and older who visited the Medical Center at Ho Chi Minh City for a health check-up. Following the exclusion criteria, 6677 subjects were included in the analysis.
Age ≤40 years, male gender, body mass index >23 kg/m, diastolic blood pressure >85 mm Hg, cholesterol >5.2 mmol/L, triglyceride >1.7 mmol/L, positivity, anti-hepatitis C virus positivity and fatty liver (p<0.05) were associated with higher ALT level (>40 U/L). Without considering age and gender, healthy group is defined after exclusion of participants with one of the mentioned contributing factors. The median ALT level in the healthy group was 18 in men and 13 in women. The ULN at the 95th percentile of the healthy group was 40 U/L in men and 28 U/L in women.
The ULN for ALT in healthy women was lower than in healthy men. Updated ULN for ALT level can promote the identification of unhealthy subjects. More studies that involve ethnicity and lifestyle factors are needed to confirm the new ULN in the Vietnamese population.
丙氨酸氨基转移酶（ALT）是肝损伤的标志物，其范围可受到病毒性肝炎、酒精性肝炎和非酒精性脂肪性肝病的影响。我们旨在研究与较高 ALT 水平相关的因素，并更新越南人群的正常上限（ULN）。
这项横断面研究纳入了 8383 名年龄在 18 岁及以上、在胡志明市医疗中心进行健康检查的成年人。经过排除标准，有 6677 名受试者纳入分析。
年龄≤40 岁、男性、体质指数（BMI）>23kg/m、舒张压>85mmHg、胆固醇>5.2mmol/L、甘油三酯>1.7mmol/L、乙型肝炎病毒阳性、丙型肝炎病毒阳性和脂肪肝（均 P<0.05）与较高的 ALT 水平（>40U/L）相关。不考虑年龄和性别，在排除具有上述一个以上相关因素的参与者后，将健康组定义为无相关因素的组。男性健康组的中位 ALT 水平为 18U/L，女性为 13U/L。健康组第 95 百分位数的 ULN 为男性 40U/L，女性 28U/L。
健康女性的 ALT ULN 低于健康男性。更新的 ALT 水平 ULN 有助于识别不健康的个体。需要更多涉及种族和生活方式因素的研究来确认越南人群的新 ULN。
