Anthropometric Indices in Adults: Which Is the Best Indicator to Identify Alanine Aminotransferase Levels?

Abstract

Background: To evaluate the correlations between serum alanine aminotransferase (ALT) levels and anthropometric indices including body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), and a new body index, the A Body Shape Index (ABSI) in Chinese adults.

Methods: A multicenter, cross-sectional study was conducted in rural areas of China in 2012-2013, and 11,331 adults were included in our final analysis.

Results: BMI, WC, HC, WHtR, WHR and ABSI were significantly positively correlated with ALT levels. Spearman rank test showed that WHtR (r = 0.346 for men, r = 0.282 for women, both p < 0.001) had the highest correlation coefficient for ALT level, whereas ABSI showed the lowest, and the correlation coefficient of each measure was higher in men than that in women. Comparing the lowest with the highest quintile of each anthropometric measure, the multivariate logistic model presented that WHtR had the superiority of identifying the presence of elevated ALT (OR 4.38; 95% CI 3.15-6.08 for men, OR 4.29; 95% CI 2.91-6.33 for women, both p < 0.001), and the ABSI was the poorest predictor in men (OR 2.51; 95% CI 1.93-3.27, p < 0.001). No association was observed for ABSI in women.

Conclusions: Our results indicated that BMI, WC, HC, WHtR and WHR were able to determine elevated ALT presence, while ABSI was not capable. WHtR and to some extent BMI were the best body indices, for predicting the ALT levels in this population. Nevertheless, the predictive ability of ABSI as a novel body index was not superior compared to established anthropometric indices.

Keywords: alanine aminotransferase; body mass index; cross-sectional; waist circumference; waist-to-height ratio.

Figure 1

The discriminatory power of BMI, WC, HC, WHtR, WHR and ABSI in the prediction of elevated ALT. Area under the Receiver Operating Characteristic curve of BMI, WC, HC, WHtR, WHR and ABSI to identify subjects with elevated ALT according to sex. Abbreviations: BMI, body mass index; WC, waist circumference; HC, hip circumference; WHtR, waist-to-height ratio; WHR, waist-to-hip ratio; ABSI, a body shape index.