조찬영 (울산대학교 의과대학, 서울아산병원) | 한빛사논문 > 한빛사

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울산대학교 의과대학, 서울아산병원

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Clin. Gastroenterol. Hepatol., May 13 2024, S1542-3565(24)00439-7 | https://doi.org/10.1016/j.cgh.2024.04.031 Updated Reference Intervals for Alanine Aminotransferase in a Metabolically and Histologically Normal Population

Jonggi Choi MD, PhD ^1,∗, Chanyoung Jo MD ^1,∗, Sollip Kim MD, PhD ², Mi Ryu RN ¹, Won-Mook Choi MD, PhD ¹, Danbi Lee MD, PhD ¹, Ju Hyun Shim MD, PhD ¹, Kang Mo Kim MD, PhD ¹, Young-Suk Lim MD, PhD¹, Han Chu Lee MD, PhD ¹

¹Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

²Department of Laboratory Medicine, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea

^∗These authors contributed equally to this work.

Corresponding Author: Jonggi Choi, M.D., Ph.D.

Abstract

This study aims to reevaluate upper reference limit (URL) for alanine aminotransferase (ALT) by considering the changing epidemiology of major liver diseases. We employed histological and metabolic parameters in Asian living liver donors. We performed a retrospective analysis of 5,455 potential living liver donors from 2005 to 2019. Participants were screened for hepatitis B, C, HIV, and alcohol use. Histologically and metabolically healthy participants were assessed using the Prati criteria (body mass index <23 kg/m ², triglyceride ≤200 mg/dL, fasting glucose ≤105 mg/dL, total cholesterol ≤220 mg/dL). The updated ALT-URL was determined as the 95th percentile among participants without hepatic steatosis and who met the Prati criteria. The median age was 30 years, with a male predominance (66.2%). Among 5,455 participants, 3,162 (58.0%) showed no hepatic steatosis, with 1,553 (49.1%) meeting both the criteria for no steatosis and the Prati criteria for metabolic health. The updated URL for ALT in these participants was 34 U/L for males and 22 U/L for females, which was significantly lower than conventionally accepted values. Using this revised ALT-URL, 72.8% of males with ALT levels ≥34 U/L and 55.0% of females with ALT levels ≥22 U/L showed signs of steatosis, while 32.7% of males and 22.2% of females met the criteria for metabolic syndrome. Our study provided the newly established reference intervals for ALT levels in a metabolically and histologically verified Asian population. The proposed URL for ALT are 34 U/L and 22 U/L for males and females, respectively.

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형식Research article
게재일2024년 05월 (BRIC 등록일 2024-05-17)
연구진국내 연구진
분야 의약학 > 응용의학

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