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High-normal levels of ALT are associated with atherogenesis

A study in December's issue of Gastroenterology investigates association between high-normal levels of alanine aminotransferase and risk factors for atherogenesis.

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Liver disease has been associated with cardiovascular disorders, but little is known about the relationship between serum levels of alanine aminotransferase (ALT) and markers of atherogenesis.

Dr Shadab Siddiqui and colleagues from Virginia, USA investigated the relationship between low–normal and high–normal levels of ALT, and an extended panel of cardiovascular risk factors among individuals with no known diseases in a primary care setting.

The researchers performed a retrospective analysis of data collected from 6442 asymptomatic patients at wellness visits to a primary care setting in central Virginia from 2010 through 2011.

Serum levels of ALT were compared with levels of lipids and lipoproteins, as well as metabolic, inflammatory, and coagulation-related factors associated with risk for cardiovascular disease.

Serum levels of ALT were in the high–normal range in 25%
Gastroenterology

The researchers found that serum levels of ALT were higher than 40 IU/L in 12% of subjects, and in the high–normal range in 25% of subjects.

ALT level was associated with the apolipoprotein B level, concentration and particle size of very-low-density lipoproteins, concentration of low-density lipoprotein (LDL) particles (LDL-P), and percentages of small dense LDL (sdLDL) and sdLDL-cholesterol (sdLDL-C).

The team noted that a high–normal level of ALT was associated with higher levels of LDL-C, LDL-P, sdLDL-C, and sdLDL particles.

These effects were independent of age, body mass index, and hyperinsulinemia. Increasing levels of ALT and fasting hyperinsulinemia (>12 μU/mL) synergized with increasing levels of triglycerides, very-low-density lipoprotein particles, LDL-P, sdLDL-C, and percentage of sdLDL-C.

The research team observed that levels of APOA1, high-density lipoprotein-cholesterol, and high-density lipoprotein-class 2 were associated inversely with serum level of ALT.

Dr Siddiqui's team concludes, "In an analysis of asymptomatic individuals, increased serum levels of ALT (even high–normal levels) are associated with markers of cardiovascular disease."

Gastroenterology 2013: 145(6): 1271-1279.e3
06 December 2013

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