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Review
. 2014 Jun 26;11(9):925-35.
doi: 10.7150/ijms.8951. eCollection 2014.

Alanine aminotransferase-old biomarker and new concept: a review

Zhengtao Liu  1 , Shuping Que  2 , Jing Xu  1 , Tao Peng  1
Affiliations
Review

Alanine aminotransferase-old biomarker and new concept: a review

Zhengtao Liu et al. Int J Med Sci. .

Abstract

Measurement of serum alanine aminotransferase (ALT) is a common, readily available, and inexpensive laboratory assay in clinical practice. ALT activity is not only measured to detect liver disease, but also to monitor overall health. ALT activity is influenced by various factors, including viral hepatitis, alcohol consumption, and medication. Recently, the impact of metabolic abnormalities on ALT variation has raised concern due to the worldwide obesity epidemic. The normal ranges for ALT have been updated and validated considering the metabolic covariates in the various ethnic districts. The interaction between metabolic and demographic factors on ALT variation has also been discussed in previous studies. In addition, an extremely low ALT value might reflect the process of aging, and frailty in older adults has been raised as another clinically significant feature of this enzyme, to be followed with additional epidemiologic investigation. Timely updated, comprehensive, and systematic introduction of ALT activity is necessary to aid clinicians make better use of this enzyme.

Keywords: ALT; activity; serum alanine aminotransferase.

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Conflict of interest statement

Conflict of interest: The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The transaminationreaction catalyzed by alanine aminotransferase.
Figure 2
Figure 2
Pooled reported ULN of ALT values by categories. a the others is represented as Australian and African. b Group A includes the studies without exclusion of subjects with metabolic abnormity when evaluating the ULN of ALT value. c Group B includes the studies with exclusion of subjects with metabolic abnormity when evaluating the ULN of ALT value. P-value is based on the comparison of ALT ULN classified by different categories (by Mann-Whitney U test).
Figure 3
Figure 3
Strategy diagram of checking the subjects with ALT assay (on the ideal status). a the extremely low ALT value is represented as lower than the median value. b the Older subjects are indicative of the subjects aged > 70 years. c the Younger subjects are indicative of the subjects aged≤70 years. d Viral biomarkers includes the hepatitis B virus surface antigen, and the anti-HCV. e Metabolic covariates includes the BMI, triglyceride, high density lipoprotein cholesterol, glucose, and blood pressure et al expressed as a series of metabolic status.
See this image and copyright information in PMC

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