低ALT是否需要治疗-19th 亚太肝脏学会会议

MP4

Liver Int. 2012 Jul;32(6):937-44. doi: 10.1111/j.1478-3231.2011.02749.x. Epub 2012 Jan 20.
Upper normal threshold of serum alanine aminotransferase in identifying individuals at risk for chronic liver disease.
Park HN, Sinn DH, Gwak GY, Kim JE, Rhee SY, Eo SJ, Kim YJ, Choi MS, Lee JH, Koh KC, Paik SW, Yoo BC.
SourceDepartment of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

Abstract
BACKGROUND/AIMS: Serum alanine aminotransferase (ALT) is an easily available, low-cost screening tool for detecting silent chronic liver disease. Recent studies have suggested that the currently accepted healthy ALT thresholds be lowered.

METHODS: In this retrospective cross-sectional study, we determined upper thresholds for ALT values in a nationally representative healthy cohort (n = 3337) from the Fourth Korea National Health and Nutrition Examination Survey (KNHANES IV). Sensitivity and specificity of the currently used ALT threshold (40 IU/L, regardless of gender) was compared against study-derived, gender-specific ALT thresholds for detecting individuals at risk for chronic liver disease in 27 913 health check-up participants.

RESULTS: The 95th percentile levels for ALT in healthy weight, metabolically normal, liver disease-free KNHANES participants were 34 IU/L for men and 25 IU/L for women. The prevalence of ALT elevation among health check-up participants was 11.0% in currently used thresholds, and increased to 22.6% with study-derived, gender-specific thresholds. Of the population who were additionally defined to have elevated ALT levels under new ALT threshold, 65.7% were at risk for chronic liver disease. Sensitivity for detecting individuals at risk for chronic liver disease improved from 18 to 33% with new thresholds whereas a trade-off in specificity (from 96 to 88%) was observed.

CONCLUSIONS: It is recommendable to lower the current ALT thresholds to better identify individuals at risk for chronic liver disease.
http://www.ncbi.nlm.nih.gov/pubmed/22260521
韩国
男34，女25

生来受罪

看不懂啊，，