Abnormal liver function test results are related to metabolic syndrome and BMI in Taiwanese adults without chronic hepatitis B or C

Abstract

Background: Metabolic syndrome (MS) is considered a cause of abnormal deposition of fat into hepatocytes, which might be associated with hepatic steatosis or abnormal liver function. Objective: The aim of this study was to explore the factors associated with MS and the relationship between MS and abnormal aspartate aminotransferase (AST), alanine aminotransferase (ALT) and g-glutamyl transferase (GGT) levels in Taiwanese subjects without chronic hepatitis B (CHB) or C (CHC). Subjects: We enrolled 2539 Taiwanese adults without CHB or CHC (age range: 16-88 years old) and investigated the factors related to MS using the NCEP-ATP (National Cholesterol Education Program-Adult Treatment Panel) III criteria; body mass index (BMI) was measured using Asia-Pacific criteria. Results: The prevalence rate of MS in Taiwanese adults without CHB or CHC was 16.9% using the modified ATP III criteria and 15.4% using the International Diabetes Federation criteria. Males had a significantly higher prevalence rate than females (Po0.001), and subjects with MS were significantly older and had significantly higher BMI values and AST, ALT and GGT levels (all Po0.001). In univariate analyses, the abnormality of liver function test results were related to gender, level of fasting sugar, systolic blood pressure, triglyceride, high-density lipoprotein, BMI and MS (all Po0.05). Multivariate analysis showed that the male gender, a higher BMI value and MS were related to abnormal liver function test results. The cutoff value for ALT in relation to MS is 31 IU l À1 for male and 18 IU l À1 for female.

Waist circumference, body mass index, serum uric acid, blood sugar, and triglyceride levels are important risk factors for abnormal liver function tests in the Taiwanese population

“…In our study, BMI was found to be related to abnormal AST and ALT levels, a result that was also obtained in our previous small-scale study [7]. In addition, waist circumference, one component of MS, is an indicator of obesity, and we therefore believe that a larger waist circumference might be related to abnormal liver function via a mechanism similar to that of a higher BMI value, which might be related to insulin resistance and NASH, and may explain why waist circumference was found to be related to abnormal AST and ALT levels in our study.…”

“…On the other hand, insulin resistance is a particular danger and can lead to mitochondrial damage, intracellular beta-oxidation, and fat depositionwithin hepatocytes [23], inducing the destruction of hepatocytes and abnormal increases in hepatic enzyme levels. In our study, abnormal AST and ALT levels were found to be related to uric acid, triglyceride, and fasting sugar levels and male gender, and in our previous small-scale study, MS was identified as being related to abnormal AST and ALT levels [7]. We therefore consider it reasonable to propose that components of MS, such as waist circumference, triglyceride level, and fasting sugar level, are related to abnormal AST and ALT levels.…”

“…In our study, BMI and waist circumference were found to be related to AST and ALT, and the odds ratio and standardized coefficients for waist circumference were larger than those for BMI. Owing to the definition of BMI, a higher BMI is not always indicative of central obesity, even though BMI is related to MS [7]. Therefore, we can suppose that waist circumference might be a more suitable indicator of abnormal liver function than BMI, and we encourage the measurement of waist circumference in health examinations.…”

“…In our previous small-scale study, we reported that MS, as defined by both the modified Third Report of the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP-III) and the International Diabetes Federation criteria for Asians, was related to abnormal liver function test results in patients with nonchronic hepatitis B and chronic hepatitis C [7]. In addition, we suggested that the possible mechanism underlying the associations between obesity and MS and abnormal hepatic enzymes might be related to insulin resistance (IR), which could lead to hepatic steatosis or even nonalcoholic steatohepatitis (NASH) [8].…”

Inflammation and Biochemical Features of Bariatric Candidates: Does Gender Matter?

“…Such pattern of AST and ALT has been identified in surveys of overweight and obese Chinese males [14], in spite of the fact that some defend its association with white ethnic groups only [15]. In the present cohort the difference was notorious (P=0.000).…”