Association of serum alanine aminotransferase and γ-glutamyltransferase levels within the reference range with metabolic syndrome and nonalcoholic fatty liver disease
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Background/Aims: Nonalcoholic fatty liver disease (NAFLD) has recently been found to be a novel component of metabolic syndrome (MS), which is one of the leading causes of chronic liver disease. The serum alanine aminotransferase (ALT) and γ-glutamyltransferase (GGT) levels are suggested to affect liver fat accumulation and insulin resistance. We assessed the associations of serum ALT and GGT concentrations within the reference ranges with MS and NAFLD. Methods: In total, 1,069 subjects enrolled at the health promotion center of Wonkwang University Hospital were divided into 4 groups according to serum ALT and GGT concentrations levels within the reference ranges. We performed biochemical tests, including liver function tests and lipid profiles, and diagnosed fatty liver by ultrasonography. Associations of ALT and GGT concentrationgrading within the reference range with fatty liver and/or MS were investigated. Results: The presence of MS, its components, and the number of metabolic abnormalities [except for high-density lipoprotein-cholesterol (HDL-C) and fasting blood glucose] increased with the ALT level, while the presence of MS, its components, and the number of metabolic abnormalities (except for HDL-C) increased with the GGT level. The odds ratios for fatty liver and MS increased with the ALT level (P<0.001 and P=0.049, respectively) and the GGT level (P=0.044 and P=0.039, respectively). Conclusions: Serum ALT and GGT concentrations within the reference ranges correlated with the incidence of NAFLD and MS in a dose-dependent manner. There associations need to be confirmed in large, prospective studies.
Abstract
Background/Aims: Nonalcoholic fatty liver disease (NAFLD) has recently been found to be a novel component of metabolic syndrome (MS), which is one of the leading causes of chronic liver disease. The serum alanine aminotransferase (ALT) and γ-glutamyltransferase (GGT) levels are suggested to affect liver fat accumulation and insulin resistance. We assessed the associations of serum ALT and GGT concentrations within the reference ranges with MS and NAFLD. Methods: In total, 1,069 subjects enrolled at the health promotion center of Wonkwang University Hospital were divided into 4 groups according to serum ALT and GGT concentrations levels within the reference ranges. We performed biochemical tests, including liver function tests and lipid profiles, and diagnosed fatty liver by ultrasonography. Associations of ALT and GGT concentrationgrading within the reference range with fatty liver and/or MS were investigated. Results: The presence of MS, its components, and the number of metabolic abnormalities [except for high-density lipoprotein-cholesterol (HDL-C) and fasting blood glucose] increased with the ALT level, while the presence of MS, its components, and the number of metabolic abnormalities (except for HDL-C) increased with the GGT level. The odds ratios for fatty liver and MS increased with the ALT level (P<0.001 and P=0.049, respectively) and the GGT level (P=0.044 and P=0.039, respectively). Conclusions: Serum ALT and GGT concentrations within the reference ranges correlated with the incidence of NAFLD and MS in a dose-dependent manner. There associations need to be confirmed in large, prospective studies.
참고문헌 (38)
- McCullough AJ, "The epidemiology and risk factors of NASH, In Fatty Liver Disease: NASH and Related Disorders", pp.23~37 (2005), Blackwell
- Farrell GC, "Nonalcoholic fatty liver disease: From steatosis to cirrhosis", Hepatology, 43(1), pp.99~112 (2006)
- Fan JG, "Fatty liver and the metabolic syndrome among Shanghai adults", J Gastroenterol Hepatol, 20, pp.1825~1832 (2005)
- 박승하, "Prevalence and risk factors of non-alcoholic fatty liver disease among Korean adults", JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, 21, pp.138~143, BLACKWELL PUBLISHING
- Hamaguchi M, "The metabolic syndrome as a predictor of nonalcoholic fatty liver disease", Ann Intern Med, 143, pp.722~728 (2005)
- Bugianesi E, "Insulin resistance: a metabolic pathway to chronic liver disease", Hepatology, 42, pp.987~1000 (2005)
- 박승하, "Insulin resistance and C-reactive protein as independent risk factors for non-alcoholic fatty liver disease in non-obese Asian men", JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, 19, pp.694~698, BLACKWELL PUBLISHING
- Kerner A, "Association between elevated liver enzymes and C-reactive protein: possible hepatic contribution to systemic inflammation in the metabolic syndrome", Arterioscler Thromb Vasc Biol, 25, pp.193~197 (2005)
- Marchesini G, "Nonalcoholic fatty liver disease: a feature of the metabolic syndrome", Diabetes, 50, pp.1844~1850 (2001)
- Dixon JB, "Weight loss and non-alcoholic fatty liver disease: falls in gamma-glutamyl transferase concentrations are associated with histologic improvement", Obes Surg, 16, pp.1278~1286 (2006)
- Vozarova B, "High alanine aminotransferase is associated with decreased hepatic insulin sensitivity and predicts the development of type 2 diabetes", Diabetes, 51, pp.1889~1895 (2002)
- Lee DH, "Association between serum gamma-glutamyltransferase and C-reactive protein", Atherosclerosis, 178, pp.327~330 (2005)
- Whitfield JB, "Gamma glutamyl transferase", Crit Rev Clin Lab Sci, 38, pp.263~355 (2001)
- Lee DH, "Is serum gamma glutamyltransferase a marker of oxidative stress", Free Radic Res, 38, pp.535~539 (2004)
- Marchesini G, "NASH: from liver diseases to metabolic disorders and back to clinical hepatology", Hepatology, 35, pp.497~499 (2002)
- Saito T, "Impact of metabolic syndrome on elevated serum alanine aminotransferase levels in the Japanese population", Metabolism, 58, pp.1067~1075 (2009)
- Oh SY, "The association between increased alanine aminotransferase activity and metabolic factors in nonalcoholic fatty liver disease", Metabolism, 55, pp.1604~1609 (2006)
- Schindhelm RK, "Alanine aminotransferase predicts coronary heart disease events: a 10-year follow-up of the Hoorn Study", Atherosclerosis, 191, pp.391~396 (2007)
- Goessling W, "Aminotransferase levels and 20-year risk of metabolic syndrome, diabetes, and cardiovascular disease", Gastroenterology, 135, pp.1935~1944 (2008)
- Chang Y, "Higher concentrations of alanine aminotransferase within the reference interval predict nonalcoholic fatty liver disease", Clin Chem, 53, pp.686~692 (2007)
- Kim HC, "Normal serum aminotransferase concentration and risk of mortality from liver diseases: prospective cohort study", BMJ, 328, pp.983~ (2004)
- Penn R, "Is serum gamma-glutamyltransferase a misleading test", Br Med J (Clin Res Ed), 286, pp.531~535 (1983)
- Goldberg DM, "Structural, functional, and clinical aspects of gamma-glutamyltransferase", CRC Crit Rev Clin Lab Sci, 12, pp.1~58 (1980)
- Kim CH, "Association of serum gamma-glutamyltransferase and alanine aminotransferase activities with risk of type 2 diabetes mellitus independent of fatty liver", Diabetes Metab Res Rev, 25, pp.64~69 (2009)
- 이병완, "Serum gamma-glutamyltransferase within its normal concentration range is related to the presence of diabetes and cardiovascular risk factors", DIABETIC MEDICINE, 22, pp.1134~1140, BLACKWELL PUBLISHING
- Kang YH, "The association of serum gamma glutamyltransferase with components of the metabolic syndrome in the Korean adults", Diabetes Res Clin Pract, 77, pp.306~313 (2007)
- Lee MY, "Relationship between gamma-glutamyltransferase and metabolic syndrome in a Korean population", Diabetic Medicine, 25, pp.469~475 (2008), BLACKWELL PUBLISHING
- Saverymuttu SH, "Ultrasound scanning in the detection of hepatic fibrosis and steatosis", Br Med J, 292, pp.13~15 (1986)
- Alberti KG, "IDF Epidemiology Task Force Consensus Group. The metabolic syndrome--a new worldwide definition", Lancet, 366, pp.1059~1062 (2005)
- Tiikkainen M, "Effects of identical weight loss on body composition and features of insulin resistance in obese women with high and low liver fat content", Diabetes, 52, pp.701~707 (2003)
- Vozarova B, "High alanine aminotransferase is associated with decreased hepatic insulin sensitivity and predicts the development of type 2 diabetes", Diabetes, 51, pp.1889~1895 (2002)
- Schindhelm RK, "Alanine aminotransferase as a marker of non-alcoholic fatty liver disease in relation to type 2 diabetes mellitus and cardiovascular disease", Diabetes Metab Res Rev, 22, pp.437~443 (2006)
- O’Brien RM, "Regulation of gene expression by insulin", Biochem J, 278, pp.609~619 (1991)
- Ceriello A, "Is oxidative stress the pathogenic mechanism underlying insulin resistance, diabetes, and cardiovascular disease? The common soil hypothesis revisited", Arterioscler Thromb Vasc Biol, 24, pp.816~823 (2004)
- Targher G, "Decreased plasma adiponectin concentrations are closely associated with nonalcoholic hepatic steatosis in obese individuals", Clin Endocrinol (Oxf), 61, pp.700~703 (2004)
- Yokoyama H, "Inverse association between serum adiponectin level and transaminase activities in Japanese male workers", J Hepatol, 41, pp.19~24 (2004)
- López-Bermejo A, "Adiponectin, hepatocellular dysfunction and insulin sensitivity", Clin Endocrinol (Oxf), 60, pp.256~263 (2004)
- Burgert TS, "Alanine aminotransferase levels and fatty liver in childhood obesity: associations with insulin resistance, adiponectin, and visceral fat", J Clin Endocrinol Metab, 91, pp.4287~4294 (2006)
