Serum Levels of Alanine Aminotransferase Decrease With Age in Longitudinal Analysis

Abstract

Background & Aims An increased level of alanine aminotransferase (ALT) is a marker of liver injury. The mean ALT level has been reported to decrease with age; we performed a longitudinal analysis to determine whether serum levels of ALT changes with age among community-dwelling, older adults in the US. Methods We analyzed clinical data from 2 cohorts of individuals who participated in the Rancho Bernardo Study, in Southern CA. The first cohort comprised 1073 community-dwelling participants (59% women); clinical data was collected from 1984 to 1987 and 1992 to 1997. The second cohort comprised 416 participants (64% women); data was collected from 1984 to 1987, 1992 to 1997, and 1997 to 1999. Demographic, metabolic covariates, ALT, bilirubin, and albumin were measured. Changes in individual ALT over time were examined in unadjusted and multivariable-adjusted linear and logistic regression analyses. Results At the baseline visit, the patients’ mean age was 65.7 years and body mass index was 24.9 kg/m2. In cohort 1, the mean levels of ALT decreased with age by 10% (from 21 to 19 IU/L) between the time periods of 1984–1987 and 1992–1997 (P<.0001). In cohort 2, they decreased by 20% (from 20 to 16 IU/L) between the time periods of 1984–1987 and 1997–1999 (P<.0001). Categorically-defined increases in ALT also decreased with age (P<.0001). Results remained consistent in sex-specific analyses and after adjusting for metabolic syndrome components, alcohol use, bilirubin, and serum levels of albumin (P<.0001). Conclusions In a longitudinal analysis, we observed that levels of ALT decrease with age, independent of sex, metabolic factors, alcohol use, and results from commonly used liver function tests (bilirubin and albumin). When interpreting serum levels of ALT, physicians should consider patients’ age especially in elderly.

Associations Between Liver Function, Bone Turnover Biomarkers and Adipokines in Older Patients With Hip Fracture

“…Our results are consistent with many studies that have shown that elevated liver markers are not only sensitive indicators of hepatobiliary diseases and alcohol consumption, but even within reference range, as in the present study, are associated with a variety of common diseases, such as CAD, AF, DM, dementia, PD [28][29][30][31][32][33], and mortality [34][35][36][37] independently of alcohol consumption. Reported in the literature age and gender-based differences in liver [32,[34][35][36] and bone turnover markers [38][39][40][41][42], as well as in three studied adipokines [43][44][45][46] were confirmed within our study population, specifically, the decrease of transaminase activities and increase of bone turnover (OC and NTx/Cr) with ageing, and higher levels of urinary bone resorption markers and circulating adiponectin and leptin in women than in men.…”

“…Reported in the literature age and gender-based differences in liver [32,[34][35][36] and bone turnover markers [38][39][40][41][42], as well as in three studied adipokines [43][44][45][46] were confirmed within our study population, specifically, the decrease of transaminase activities and increase of bone turnover (OC and NTx/Cr) with ageing, and higher levels of urinary bone resorption markers and circulating adiponectin and leptin in women than in men.…”

Association of Serum Bilirubin with Aging and Mortality

“…Height (meters) and weight (kilogram) were measured, and body mass index (BMI) was calculated as weight in kg divided by height in meter squared (kg/m 2 ). 12,30–33 …”

Alanine Aminotransferase-Old Biomarker and New Concept: A Review

“…Specifically, age has been shown to be associated with the ALT level in prior cross-sectional and prospective studies 11-13. Elinav et al 12 reported an inverted curve with peak ALT levels at 40-55 years in a group of Israeli participants.…”