Upper limit of normal serum alanine aminotransferase levels in Japanese subjects.

Abstract

AIM:

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 hepatitis B surface antigen and hepatitis C virus 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, the following were independently associated with ALT concentration by multivariate analysis: sex; age; body mass index; waist circumference; concentrations of total cholesterol, high-density lipoprotein cholesterol, triglycerides and fasting blood glucose; and fatty liver on ultrasonography. Healthy subjects consisted of 1462 (21.2%) men and 2046 (45.4%) women, and the 90th percentiles of the ALT levels in the two groups were 29 and 23 IU/L, respectively.

CONCLUSION:

The upper limits of normal ALT when considering lifestyle factors in Japanese subjects were 29 IU/L in men and 23 IU/L in women.

• Authors: Kenichi Tanaka, Hideyuki Hyogo, Masafumi Ono, Hirokazu Takahashi, Yoichiro Kitajima, Naofumi Ono, Takahisa Eguchi, Kazuma Fujimoto, Kazuaki Chayama, Toshiji Saibara, Keizo Anzai, Yuichiro Eguchi, Japan Study Group of Non-alcoholic Fatty Liver Disease (JSG-NAFLD)
• Journal: Hepatology research : the official journal of the Japan Society of Hepatology (Hepatol Res) Vol. 44 Issue 12 Pg. 1196-207 (Nov 2014) ISSN: 1386-6346 [Print] Netherlands
• PMID: 24372862 (Publication Type: Journal Article)
• Copyright: © 2013 The Japan Society of Hepatology.