The healthy range for serum ALT and the clinical significance of “unhealthy” normal ALT levels in the Korean population

Hyun Seok Kang 1, Soon Ho Um 1, Yeon Seok Seo 1,*, Hyonggin An 2, Kwang Gyun Lee 1, Jong Jin Hyun1, Eun Sun Kim 1, Sung Chul Park 1, Bora Keum 1, Ji Hoon Kim 1, Hyung Joon Yim 1, Yoon Tae Jeen1, Hong Sik Lee 1, Hoon Jai Chun 1, Chang Duck Kim 1, Ho Sang Ryu 1

Journal of Gastroenterology and Hepatology
Accepted Article (Accepted, unedited articles published online for future issues)
DOI: 10.1111/j.1440-1746.2010.06481.x
Journal compilation © 2010 Journal of Gastroenterology and Hepatology Foundation

Author Information

1 Departments of Internal Medicine and
2 Biostatistics, Korea University College of Medicine, Seoul, Korea

* Correspondence: Yeon Seok Seo,

* Correspondence: Yeon Seok Seo, MD, PhD Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Anam Hospital, Korea University College of Medicine, Anam-dong 5-ga, Seongbuk-gu, Seoul 136-705, Korea Tel: 82-2-920-6608, Fax: 82-2-953-1943, E-mail: drseo@korea.ac.kr

Publication History
Accepted manuscript online: 17 AUG 2010 12:20PM EST
Accepted date: 02 August 2010

Keywords:
aminotransferase;metabolic syndrome;insulin resistance;nonalcoholic fatty liver disease

ABSTRACT

Background and Aims: It remains unclear whether the currently used normal range for serum alanine aminotransferase (ALT) levels really reflects a healthy liver. This study was performed to evaluate the healthy range of serum ALT in the Korean adult population and to determine the clinical significance of unhealthy levels.

Methods: We reviewed the medical records, including questionnaires and the results of laboratory and radiologic tests conducted at the Health Promotion Center in Korea University Anam Hospital between March 2005 and February 2007. The records written in questionnaire form included the baseline data, including physical status, social behaviors, medication history, and past and present disease histories.

Results: The mean age of the 7403 enrolled subjects was 48 years, and 49.9% of them were men. A healthy cohort was selected after excluding subjects who showed any abnormalities of the factors that were significantly associated with serum ALT level on multivariate regression analysis. The upper limit of the healthy range of serum ALT level (i.e., 95th percentile) in the healthy population was 31 IU/L for the men and 23 IU/L for the women. The prevalence of metabolic syndrome and insulin resistance were significantly higher in subjects with an “unhealthy” normal ALT level than in subjects with a healthy ALT level.

Conclusion: In our study, the upper limit of the healthy range of serum ALT level was 31 IU/L for the men and 23 IU/L for the women. An unhealthy normal ALT level was associated with higher prevalence of metabolic syndrome and insulin resistance.

Source