Correlation between serum alanine aminotransferase activity and age: An inverted U curve pattern
Correlation between serum alanine aminotransferase activity and age: An inverted U curve pattern
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DOI：
10.1111/j.1572-0241.2005.41822.x
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发表时间：
2005-10-01
影响因子：
9.8
通讯作者：
Ackerman, Z
中科院分区：
文献类型：
--
作者：
Elinav, E;Ben-Dov, IZ;Ackerman, Z
背景：丙氨酸转氨酶（ALT）活性是识别肝脏疾病最广泛使用的实验室检测方法。血清ALT活性值的正常限度近来受到质疑。最近这种不确定性的一个原因可能是老年人口中转氨酶水平未被认识到的下降。目的：横断面评估年龄与ALT活性之间的关系。方法：对以色列耶路撒冷三家全科诊所的老年单身住院者和成人受试者的实验室数据进行了回顾，排除了已知肝病的受试者。一个实验室完成了所有的测试。我们研究了血清转氨酶水平与年龄、性别、身体质量指数（BMI）和肾小球滤过率（GFR）的关系。采用多项式回归和方差分析（ANOVA）进行统计分析，并对多重比较进行校正。结果：包括来自老人院的128名个体和来自三个家庭诊所的207名个体。ALT活性随年龄线性回归（r = 0.22, p < 0.0001）。然而，多项式回归显示了更好的拟合（r = 0.33, p < 0.0001），形成倒U曲线，在40-55岁时达到峰值。按年龄组划分，40岁以下的血清ALT水平为19 +/- 13 U/L， 40-55岁的血清ALT水平为25 +/- 19 U/L， 56-72岁的血清ALT水平为22 +/- 10 U/L， 73-83岁的血清ALT水平为17 +/- 9 U/L， 83-100岁的血清ALT水平为13 +/- 5 U/L （p < 0.0001）。GFR （r = 0.1, p < 0.05）和BMI （r = 0.14, p < 0.01）与ALT呈弱相关，性别与ALT也有相关性；男性22 +/- 15 U/L，女性17 +/- 11 U/L （p < 0.005）。包括年龄、性别、GFR和BMI在内的多元回归分析显示，年龄（p= 0.01）和性别（p= 0.04）与ALT活性保持相关性。天冬氨酸转氨酶（AST）活性没有发现这种关联。结论：我们的数据表明年龄与血清ALT活性之间存在显著关联。这种关联不是简单的线性相关，而是倒u型关系。因此，在解释疑似肝病的受试者的实验室结果时，年龄可能应该考虑在内。需要更大规模的研究来更好地描述这一问题。
BACKGROUND: Alanine aminotransferase (ALT) activity is the most widely used laboratory test for the recognition of liver disease. Normality limits for values of serum ALT activity have been questioned lately. One reason for this recent uncertainty may be an unrecognized decline in aminotransferase levels in the aging population.AIMS: Cross-sectional evaluation of the association between age and ALT activity.METHODS: Laboratory data of residents in single home for the aged and of adult subjects in three general practice clinics in Jerusalem, Israel were reviewed, excluding subjects with known liver disease. A single laboratory performed all the tests. We examined the associations of serum aminotransferase levels with age, sex, body-mass-index (BMI), and estimated glomerular filtration rate (GFR). Polynomial regression and analysis of variance (ANOVA) with corrections for multiple comparisons were utilized for the statistical analyses.RESULTS: One hundred and twenty-eight individuals from the home for the aged and 207 individuals from three family practices were included. ALT activity linearly regressed with age (r = 0.22, p < 0.0001). However, polynomial regression revealed a better fit (r = 0.33, p < 0.0001), creating an inverted U curve with a peak at 40-55 yr. According to age groups, serum ALT level was 19 +/- 13 U/L in those under 40 yr, 25 +/- 19 U/L in 40-55 yr olds, 22 +/- 10 U/L in 56-72 yr olds, 17 +/- 9 U/L in 73-83 yr olds, and 13 +/- 5 U/L in 83-100 yr olds (p < 0.0001). GFR (r = 0.1, p < 0.05) and BMI (r = 0.14, p < 0.01) weakly correlated with ALT. Gender also associated with ALT; 22 +/- 15 U/L in men, and 17 +/- 11 U/L in women (p < 0.005). Multiple regression analysis including age, gender, GFR, and BMI revealed that age (p= 0.01) and gender (p= 0.04) retained association with ALT activity. No such associations were noted for aspartate aminotransferase (AST) activity.CONCLUSIONS: Our data suggest a significant association between age and serum ALT activity. This association is not a simple linear correlation, but rather an inverted-U-like relation. Thus, when interpreting the laboratory results of a subject suspected of liver disease, age should probably be taken into account. Larger-scale studies are needed to better characterize this issue.