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. 2010 Oct 12;5(10):e13269.
doi: 10.1371/journal.pone.0013269.

Gender difference of alanine aminotransferase elevation may be associated with higher hemoglobin levels among male adolescents

Solomon Chih-Cheng Chen  1 , Jun-Jun Yeh, Mei-Hwei Chang, Yu-Kuei Liao, Li-Chen Hsiao, Choo-Aun Neoh, Teck-Siang Tok, Jung-Der Wang
Affiliations

Gender difference of alanine aminotransferase elevation may be associated with higher hemoglobin levels among male adolescents

Solomon Chih-Cheng Chen et al. PLoS One. .

Abstract

Background: To explore the gender difference of ALT elevation and its association with high hemoglobin levels.

Methods: A cross-sectional study of 3547 adolescents (2005 females, mean age of 16.5?.3 years) who were negative for hepatitis B surface antigen received health checkups in 2006. Body mass index (BMI), levels of hemoglobin, ALT and cholesterol were measured. ALT >42 U/L was defined as elevated ALT. Elevated ALT levels were detected in 112 of the 3547 participants (3.3%), more prevalent in males than in females (5.4% vs. 1.4%, p<0.001). Hemoglobin levels had a significant linear correlation with ALT levels in both genders. Abnormal ALT started to occur if hemoglobin >11 g/dl in females or >13.5 g/dl in males, but the cumulative cases of elevated ALT increased more quickly in males. Proportion of elevated ALT increased as either the BMI or hemoglobin level rise, more apparent in male adolescents. Logistic regression modeling showed odds ratio (95% confidence interval) were 24.7 (15.0-40.6) for BMI ≥27 kg/m(2); 5.5 (2.9-10.4) for BMI 24-27 kg/m(2); 2.7 (1.3-5.5) for Q5 (top 20th percentile) hemoglobin level; and 2.6 (1.6-4.1) for male gender. Further separately fitting the logistic models for two genders, the significance of Q5 hemoglobin level only appeared in the males.

Conclusions: High hemoglobin level is a significant risk factor of ALT elevation after control hepatitis B, obesity and gender. Males have greater risk of abnormal liver function which may be associated with higher hemoglobin levels.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. The distribution of alanine aminotransferase (ALT) levels by hemoglobin levels among 3547 adolescents.
Two fitting regression lines of two genders are drawn by cubic equation with statistical significance, p<0.001.
Figure 2
Figure 2. The cumulative number of individuals with abnormal ALT has a linear correlation with the hemoglobin levels for both genders, with both regression lines being statistically significant.
The slope of the regression line is higher for males than for females: 22.95 vs. 6.27. According to the regression lines, the hemoglobin levels at which the cumulative number of abnormal ALT would be zero, are about 11.0 g/dl for females and 13.5 g/dl for males.
Figure 3
Figure 3. The proportion of individuals with abnormal alanine aminotransferase (ALT), categorized by body mass index (BMI) and quintiles of hemoglobin levels by gender.
The total numbers of individuals with abnormal ALT are 29 and 83 cases among 2005 females and 1542 males, respectively.
See this image and copyright information in PMC

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