Unexplained elevations in alanine aminotransferase in individuals with the metabolic syndrome: Results from the Third National Health and Nutrition Survey (NHANES III)
Unexplained elevations in alanine aminotransferase in individuals with the metabolic syndrome: Results from the Third National Health and Nutrition Survey (NHANES III)
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DOI：
10.1097/00000441-200503000-00001
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发表时间：
2005-03-01
影响因子：
3.1
通讯作者：
Chalasani, N
中科院分区：
文献类型：
--
作者：
Liangpunsakul, S;Chalasani, N
背景：成人 NHANES III 参与者中不明原因的丙氨酸转氨酶 (ALT) 水平升高表明存在非酒精性脂肪肝 (NAFLD)。在本研究中，我们研究了不明原因的 ALT 水平升高与代谢综合征之间的关系，以及不明原因的 ALT 水平升高与微量白蛋白尿之间的关系。方法：我们检查了 4376 名患有代谢综合征的 NHANES III 成年参与者中不明原因的 ALT 水平升高的患病率和预测因素。代谢综合征是根据成人治疗小组 III 标准定义的，而不明原因的 ALT 水平升高是根据之前发布的标准定义的。对 710 名 ALT 水平不明原因升高的个体和 1780 名对照受试者之间的微量白蛋白尿患病率进行了比较。结果：患有代谢综合征的个体中不明原因的 ALT 水平升高的发生率为 7%，显着高于无代谢综合征的个体（3.5%；OR，2.07；95% CI，1.78-2.41）。年龄较小、男性、较高的甘油三酯或血清铁水平、某些抗氧化剂水平较低以及胰岛素抵抗（或糖尿病）与代谢综合征中无法解释的 ALT 水平升高独立相关。 ALT 水平不明原因升高的个体与其对照受试者之间微量白蛋白尿的患病率没有差异（分别为 4.8% 和 6.2%；P = 0.2）。结论：代谢综合征患者的 ALT 水平不明原因升高的发生率显着较高。由于 ALT 水平无法解释的升高可能表明存在 NAFLD，因此我们的数据支持 NAFLD 是代谢综合征谱系的一部分的观点。然而，不明原因的 ALT 水平升高与微量白蛋白尿之间没有任何关系。
Background: Unexplained elevations in alanine aminotransferase (ALT) level have been suggested to signify the presence of nonalcoholic fatty liver disease (NAFLD) in adult NHANES III participants. In this study, we examined the relationship between unexplained elevations in ALT level and the metabolic syndrome and the relationship between unexplained elevations in ALT level and microalbuminuria. Methods: We examined the prevalence and predictors of unexplained elevations in ALT level in 4376 adult NHANES III participants with the metabolic syndrome. Metabolic syndrome was defined according to Adult Treatment Panel III criteria, and the presence of unexplained elevations in ALT level was defined based on the previously published criteria. Prevalence of microalbuminuria was compared between 710 individuals with unexplained elevations in ALT level and 1780 control subjects. Results: Prevalence of unexplained elevations in ALT level in individuals with the metabolic syndrome was 7% and was significantly higher than in those without the metabolic syndrome (3.5%; OR, 2.07; 95% CI, 1.78-2.41). Younger age, male gender, higher triglycerides or serum iron levels, low levels of certain antioxidants, and insulin resistance (or diabetes) were independently associated with unexplained elevations in ALT level in the metabolic syndrome. Prevalence of microalbuminuria was not different between individuals with unexplained elevations in ALT level and their control subjects (4.8% versus 6.2%, respectively; P = 0.2). Conclusions: Individuals with the metabolic syndrome have a significantly higher prevalence of unexplained elevations in ALT level. Because unexplained elevations in ALT level may signify the presence of NAFLD, our data support the notion that NAFLD is part of the spectrum of the metabolic syndrome. However, no relationship was demonstrated between unexplained elevations in ALT level and microalbuminuria.