Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Dec 29;16(1):174.
doi: 10.3390/cancers16010174.

Low Alanine Aminotransferase as a Marker for Sarcopenia and Frailty, Is Associated with Decreased Survival of Bladder Cancer Patients and Survivors-A Retrospective Data Analysis of 3075 Patients

Menachem Laufer  1   2 , Maxim Perelman  2   3 , Gad Segal  2   4 , Michal Sarfaty  2   5 , Edward Itelman  2   6   7
Affiliations

Low Alanine Aminotransferase as a Marker for Sarcopenia and Frailty, Is Associated with Decreased Survival of Bladder Cancer Patients and Survivors-A Retrospective Data Analysis of 3075 Patients

Menachem Laufer et al. Cancers (Basel). .

Abstract

Background: Sarcopenia is characterized by the loss of muscle mass and function and is associated with frailty, a syndrome linked to an increased likelihood of falls, fractures, and physical disability. Both frailty and sarcopenia are recognized as markers for shortened survival in a number of medical conditions and in cancer patient populations. Low alanine aminotransferase (ALT) values, representing low muscle mass (sarcopenia), may be associated with increased frailty and subsequently shortened survival in cancer patients. In the current study, we aimed to assess the potential relationship between low ALT and shorter survival in bladder cancer patients and survivors.

Patients and methods: This was a retrospective analysis of bladder cancer patients and survivors, both in and outpatients. We defined patients with sarcopenia as those presenting with ALT < 17 IU/L.

Results: A total of 5769 bladder cancer patients' records were identified. After the exclusion of patients with no available ALT values or ALT levels above the upper normal limit, the final study cohort included 3075 patients (mean age 73.2 ± 12 years), of whom 80% were men and 1362 (53% had ALT ≤ 17 IU/L. The mean ALT value of patients within the low ALT group was 11.44 IU/L, while the mean value in the higher ALT level group was 24.32 IU/L (p < 0.001). Patients in the lower ALT group were older (74.7 vs. 71.4 years; p < 0.001), had lower BMI (25.8 vs. 27; p < 0.001), and their hemoglobin values were lower (11.7 vs. 12.6 g/dL; p < 0.001). In a univariate analysis, low ALT levels were associated with a 45% increase in mortality (95% CI 1.31-1.60, p < 0.001). In a multivariate model controlling for age, kidney function, and hemoglobin, low ALT levels were still associated with 22% increased mortality.

Conclusions: Low ALT values, indicative of sarcopenia and frailty, are associated with decreased survival of bladder cancer patients and survivors and could potentially be applied for optimizing individual treatment decisions.

Keywords: alanine aminotransferase; bladder cancer; frailty; sarcopenia; survival.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Consort flow diagram of patients.
Figure 2
Figure 2
Kaplan Meir Survival Analysis according to ALT levels.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Davis A.A., McKee A.E., Kibbe W.A., Villaflor V.M. Complexity of Delivering Precision Medicine: Opportunities and Challenges. Am. Soc. Clin. Oncol. Educ. Book. 2018;38:998–1007. doi: 10.1200/EDBK_200279. - DOI - PubMed
    1. Delpierre C., Lefèvre T. Precision and personalized medicine: What their current definition says and silences about the model of health they promote. Implication for the development of personalized health. Front. Sociol. 2023;8:1112159. doi: 10.3389/fsoc.2023.1112159. - DOI - PMC - PubMed
    1. Precision Medicine vs Personalized Medicine | Within3. [(accessed on 17 November 2023)]. Available online: https://within3.com/blog/precision-medicine-vs-personalized-medicine.
    1. Marson F.A.L., Bertuzzo C.S., Ribeiro J.D. Personalized or precision medicine? the example of cystic fibrosis. Front. Pharmacol. 2017;8:390. doi: 10.3389/fphar.2017.00390. - DOI - PMC - PubMed
    1. Sinha P., Kallogjeri D., Piccirillo J.F. Assessment of comorbidities in surgical oncology outcomes. J. Surg. Oncol. 2014;110:629–635. doi: 10.1002/jso.23723. - DOI - PubMed

LinkOut - more resources