Husain Farah Safdar, Tey Siew Ling, Huynh Dieu Thi Thu, Oliver Jeffery, Baggs Geraldine, How Choon How, Chow Wai Leng, Cheong Magdalin, Aw Tar Choon, Chew Samuel Teong Huang, Tan Ngiap Chuan
SingHealth Polyclinics, Singapore, Singapore.
Abbott Nutrition Research and Development, Asia-Pacific Center, Singapore, Singapore.
BMC Geriatr. 2025 Aug 23;25(1):658. doi: 10.1186/s12877-025-06329-2.
Liver chemistries are used to measure liver function or damage, and it is vital to differentiate between the changes due to aging versus other causes. The literature has also reported a decline in serum alanine transaminase (ALT) in older age independent of other factors. In this study, we seek to (1) evaluate liver chemistries in healthy community-dwelling older adults, and (2) investigate the associations with age, sex, use of statins, and other factors.
This cross-sectional study included 400 older adults aged ≥ 65 years with normal nutritional status and who took part as a non-randomized reference group in the Strengthening Health In ELDerly through nutrition (SHIELD) study. Blood samples were analyzed for ALT, aspartate transaminase (AST), albumin, total bilirubin, alkaline phosphatase (ALP), total protein, and globulin. Analysis of variance and multiple linear regression models were used to evaluate the desired associations.
Mean values of all the liver chemistries were within normal laboratory reference ranges for both sex and age categories. Males had higher ALT, albumin, and total bilirubin than females (all ≤ 0.023), whereas females had higher ALP and globulin than males (both ≤ 0.015). Participants aged 65 to < 75 years had higher ALT and lower total bilirubin than those aged ≥ 75 years (both ≤ 0.020). There was a significant relationship between ALP and intensity of statin therapy ( = 0.023), in which high-intensity statin therapy had significantly higher ALP than low-intensity statin therapy ( = 0.045). However, these values were still within the normal range for ALP.
Liver chemistries in community-dwelling older adults with normal nutritional status were within the normal reference range used for adults. There were small but statistically significant differences with age, sex, and intensity of statin therapy. ALT declined with age, and further prospective studies are required to determine cut-offs for increased risk of adverse clinical outcomes.
NCT03240952.
The online version contains supplementary material available at 10.1186/s12877-025-06329-2.
肝脏生化指标用于评估肝功能或肝损伤情况，区分衰老所致变化与其他原因引起的变化至关重要。文献报道，在无其他因素影响的情况下，老年人血清丙氨酸转氨酶（ALT）水平会下降。在本研究中，我们旨在：（1）评估健康社区居住老年人的肝脏生化指标；（2）研究这些指标与年龄、性别、他汀类药物使用情况及其他因素之间的关联。
这项横断面研究纳入了400名年龄≥65岁、营养状况正常的老年人，他们作为非随机参照组参与了“通过营养强化老年人健康”（SHIELD）研究。对血液样本进行ALT、天冬氨酸转氨酶（AST）、白蛋白、总胆红素、碱性磷酸酶（ALP）、总蛋白和球蛋白的检测。采用方差分析和多元线性回归模型评估预期的关联。
所有肝脏生化指标的平均值在各性别和年龄组的实验室正常参考范围内。男性的ALT、白蛋白和总胆红素水平高于女性（均P≤0.023），而女性的ALP和球蛋白水平高于男性（均P≤0.015）。65至＜75岁的参与者ALT水平高于≥75岁者，总胆红素水平低于≥75岁者（均P≤0.020）。ALP与他汀类药物治疗强度之间存在显著关系（P = 0.023），高强度他汀类药物治疗组的ALP显著高于低强度他汀类药物治疗组（P = 0.045）。然而，这些值仍在ALP的正常范围内。
营养状况正常的社区居住老年人的肝脏生化指标在成人正常参考范围内。在年龄、性别和他汀类药物治疗强度方面存在虽小但具有统计学意义的差异。ALT随年龄下降，需要进一步的前瞻性研究来确定不良临床结局风险增加的临界值。
NCT03240952。
在线版本包含可在10.1186/s12877 - 025 - 06329 - 2获取的补充材料。
