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http://onlinelibrary.wiley.com/doi/10.1111/hepr.12293/abstract
Original Article
The upper limit of normal serum alanine aminotransferase levels in Japanese
subjects
Kenichi Tanaka1,2,
Hideyuki Hyogo4,
Masafumi Ono5,
Hirokazu Takahashi1,2,*,
Yoichiro Kitajima1,3,
Naofumi Ono1,
Takahisa Eguchi1,
Kazuma Fujimoto2,
Kazuaki Chayama4,
Toshiji Saibara5,
Keizo Anzai2,
Yuichiro Eguchi3,
and the Japan Study Group of Nonalcoholic Fatty Liver Disease (JSG-NAFLD)
DOI: 10.1111/hepr.12293
Abstract
Background
Serum alanine aminotransferase (ALT) is important for screening, diagnosis,
and management of chronic liver diseases. The incidence of non-alcoholic
fatty liver disease (NAFLD)/non-alcoholic steatohepatitis (NASH), which is
considered a hepatic manifestation of lifestyle-related diseases, is
increasing worldwide. However, the upper limit of the normal ALT level has
not yet been established because of not excluding many lifestyle-related
diseases. The aim of this study was to evaluate the upper limit of normal
serum ALT levels in Japanese subjects.
Methods
We analyzed the serum ALT levels of 11 404 Japanese subjects negative for
HBs-antigen and HCV-antibody, and who received health check-ups. Lifestyle
factors related to ALT levels were determined by multivariate analysis.
Subjects with all factors identified by multivariate analysis within the
normal range were defined as “healthy” subjects. The 90th percentile of
ALT levels in “healthy” subjects was defined as the upper limit of
normal ALT.
Results
Whereas alcohol intake was not a significant factor, gender; age; body mass
index (BMI); waist circumference; concentrations of total cholesterol,
high-density lipoprotein cholesterol, triglycerides, and fasting blood
glucose; and fatty liver on ultrasonography were independently associated
with ALT concentration by multivariate analysis. “Healthy” subjects
consisted of 1462 (21.2%) males and 2046 (45.4%) females and the 90th
percentiles of the ALT levels in the two groups were 29 IU/L in males and
23 IU/L in females.
Conclusions
The upper limits of normal ALT when considering lifestyle factors in
Japanese subjects were 29 IU/L in males and 23 IU/L in females.
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