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KMID : 0356620080230060404
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Journal of Korean Society of Endocrinology
2008 Volume.23 No. 6 p.404 ~ p.412
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Alanine Aminotransferase as a Predictor of Metabolic Syndrome in Koreans
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Kwon Ji-Hae
Ahn Young-Sung
Kang Yang-Ho
Son Suk-Man
Kim In-Ju
Kim Young-Gi
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Abstract
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Aim: Alanine aminotransferase (ALT) is associated with insulin resistance, and is independent of the general metabolic measures. Gamma-glutamyltransferase (GGT) is regarded as a predictor of diabetes mellitus. We analyzed which of ALT or GGT is better tool to preestimate the development of metabolic syndrome.
Methods: A total of 1203 Koreans who visited the Institute of Health in Pusan National University Hospital from January 2005 to August 2006 were enrolled in this cross-sectional study. Their median age was 51 years old, and the prevalence of metabolic syndrome was 16.4% (n=197). We excluded the subjects with diabetes mellitus, hypertension and viral hepatitis or those subjects with a level of alanine aminotransferase (ALT) or gamma-glutamyltransferase (r-GGT)>80 IU/L.
Results: For all the patients in the metabolic syndrome group, the median homeostatic assessment of insulin resistance (HOMA-IR), the waist circumference, the fasting blood glucose level, the systolic and diastolic blood pressure were all associated with the ALT level (P<0.05). For the nonmetabolic syndrome group, all the metabolic risk factors were associated with the ALT level (P<0.05). On logistic regression analysis, after correction for age, alcohol intake, HOMA-IR and body mass index, the logALT maintained a highly predictive value for metabolic syndrome, and this was better than the logGGT [odds ratio (OR) of logALT: 18.489, odds ratio of logGGT: 2.024] (P<0.001). The risk of developing metabolic syndrome was significantly higher in the above 50 percentile and the above 75 percentile of ALT than in the lowest quartile. [for men-OR: 3.6; 95% confidence interval (CI), 2.2-5.9; OR: 6.9; 95% CI: 4.3-10.9] [for women-OR: 2.7; 95% CI: 1.5-4.7; OR: 6.5; 95% CI: 3.8-11] (P<0.001). The cut-off value of ALT by the ROC curve was 24 IU/L for men (sensitivity: 64.3%, specificity: 66%, negative predictive value: 99.5%) and 20 IU/L for women (sensitivity: 78.9%, specificity: 61.4%, negative predictive value: 84.9%).
Conclusion: Even although patients can have an ALT level that`s included within the upper normal level, we may consider the probability that these patients will have metabolic syndrome. Furthermore, in our analysis, the ALT level is a better predictor of metabolic syndrome than the GGT level.
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KEYWORD
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alanine aminotransferase, gamma-glutamyltransferase, metabolic syndrome
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