Shao Yuhan, Zhu Hailong, Chen Xin, Feng Enqiang, Chen Chen, Shao Zhugang, Li Xiaojing, Liu Li
Qingdao Municipal Center for Disease Control and Prevention, Qingdao, Shandong, China.
Qingdao Institute of Preventive Medicine, Qingdao, Shandong, China.
Front Nutr. 2025 Mar 24;12:1513029. doi: 10.3389/fnut.2025.1513029. eCollection 2025.
This study aimed to clarify the effects of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and ALT/AST ratio on metabolically unhealthy obese (MUHO) and to estimate the predictors of MUHO in the elderly.
19,812 individuals aged 65 years and older from a health check-up in Qingdao, China in 2021 were chosen as subjects in the current study. Binary logistic regression models were performed to evaluate the relationship between ALT, AST, ALT/AST ratio and MUHO. Receiver operating characteristic (ROC) analysis was performed to estimate the predictive value of ALT, AST and ALT/AST ratio for the diagnosis of MUHO.
The risks for MUHO increased across quartiles of ALT level and ALT/AST ratio in both genders. The adjusted odds ratios (ORs) for MUHO in the highest quartile of ALT were 3.20-fold higher than the reference quartile in men and 3.05-fold higher in women. Compared with the first quartile of ALT/AST ratio, the adjusted ORs for MUHO in the highest quartile were 3.64 (95% CI: 3.17-4.19) in men and 3.60 (95% CI: 3.11-4.16) in women, respectively. In ROC curve analysis for predicting MUHO, the area under the ROC curve (AUC) values were 0.63 ( < 0.001) for ALT and 0.64 ( < 0.001) for ALT/AST ratio in men, and 0.62 ( < 0.001) for ALT and 0.64 ( < 0.001) for ALT/AST ratio in women. However, AST was not significantly associated with MUHO both in men and in women (>0.05).
ALT and ALT/AST ratio might be considered as two simple and reliable diagnostic indicators for MUHO in the elderly.
本研究旨在阐明丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）及ALT/AST比值对代谢不健康肥胖（MUHO）的影响，并评估老年人MUHO的预测因素。
选取2021年在中国青岛进行健康体检的19812名65岁及以上个体作为本研究的对象。采用二元逻辑回归模型评估ALT、AST、ALT/AST比值与MUHO之间的关系。进行受试者工作特征（ROC）分析以评估ALT、AST及ALT/AST比值对MUHO诊断的预测价值。
男女两性中，MUHO风险均随ALT水平四分位数及ALT/AST比值的升高而增加。ALT最高四分位数组中MUHO的校正比值比（OR）在男性中比参考四分位数高3.20倍，在女性中高3.05倍。与ALT/AST比值第一四分位数相比，最高四分位数组中MUHO的校正OR在男性中为3.64（95%CI：3.17 - 4.19），在女性中为3.60（95%CI：3.11 - 4.16）。在预测MUHO的ROC曲线分析中，男性ALT的ROC曲线下面积（AUC）值为0.63（<0.001），ALT/AST比值为0.64（<0.001）；女性ALT为0.62（<0.001），ALT/AST比值为0.64（<0.001）。然而，AST在男性和女性中均与MUHO无显著关联（>0.05）。
ALT和ALT/AST比值可被视为老年人MUHO的两个简单可靠的诊断指标。
