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Elevated serum alanine aminotransferase activity and calculated risk of coronary heart disease in the United States
Author(s) -
Ioannou George N.,
Weiss Noel S.,
Boyko Edward J.,
Mozaffarian Dariush,
Lee Sum P.
Publication year - 2006
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.21171
Subject(s) - medicine , hazard ratio , viral hepatitis , insulin resistance , nonalcoholic fatty liver disease , hepatitis c , framingham risk score , gastroenterology , national health and nutrition examination survey , alanine transaminase , fatty liver , hepatitis , obesity , endocrinology , confidence interval , disease , environmental health , population
In the United States, elevated serum alanine aminotransferase (ALT) activity in the absence of viral hepatitis or excessive alcohol consumption is most commonly attributed to nonalcoholic fatty liver disease (NAFLD). NAFLD is related to predictors of coronary heart disease (CHD) such as insulin resistance and central obesity. We examined the association between elevated serum ALT activity and the 10‐year risk of CHD as estimated using the Framingham risk score (FRS). We performed a cross‐sectional analysis comparing participants in the Third National Health and Nutrition Examination Survey with normal and elevated ALT activity (>43 IU/L), examining the mean levels of FRS. Among participants without viral hepatitis or excessive alcohol consumption, those with elevated ALT activity (n = 267) had a higher FRS than those with normal ALT activity (n = 7,259), both among men (mean difference in FRS 0.25, 95% CI 0.07‐0.4; hazard ratio for CHD 1.28, 95% CI 1.07‐1.5) and women (mean difference in FRS 0.76, 95% CI 0.4‐1.1; hazard ratio for CHD 2.14, 95% CI 1.5‐3.0). The ALT threshold for increased risk of CHD was higher in men (>43 IU/L) than in women (>30 IU/L). Elevated ALT activity was not associated with higher FRS among nonobese participants with viral hepatitis or excessive alcohol consumption. In conclusion , individuals with elevated serum ALT activity in the absence of viral hepatitis or excessive alcohol consumption, most of whom have NAFLD, have an increased calculated risk of CHD. This association is more prominent in women. (H EPATOLOGY 2006;43:1145–1151.)