Upon adjusted multivariable analysis of serial ALT values, ALT was significantly higher (mean 12%; <i>P</i> = 0.02) among those with MS at baseline and even higher (mean 19%; <i>P</i> = 0.003) among those with persistent MS compared with those with persistent absence of MS. MS was not associated with serial APRI on follow-up.
However, after adjusting for covariates (age, residential area, income, dyslipidemia medication, education, current smoking, regular exercise, alcohol consumption, body mass index, years after menopause, aspartate aminotransferase, alanine aminotransferase, and white and red blood cell counts), longer reproductive years were associated with a lower prevalence of MetS (OR 0.751, 95% CI 0.745-0.747).
In women, with increasing the quartiles of ALT within normal limits, the percent of participants with metabolic syndrome also increased significantly (P<sub>trend</sub>=0.04).
Our study confirmed a positive association between components of metabolic syndrome and elevated serum alanine aminotransferase in a Korean population.
Some studies have proposed that serum ALT levels, even those within the conventional normal range, are associated with metabolic syndrome and fatty liver.
Multivariate analyses of 2,881 patients before treatment and of 1,403 patients with a sustained virological response indicated that gender, viral factors (genotype, HCV RNA titer) and indicators of metabolic syndrome (body mass index, blood pressure, blood glucose, cholesterol and triglyceride concentration) were associated with alanine aminotransferase levels.
Lean MetS subjects were older, had more diabetes, and had higher metabolic component levels, but lower alanine transaminase and aspartate transaminase-platelet ratio index levels compared with obese MetS subjects.
Finally, serum GPI-PLD levels were strongly and independently associated with serum alanine transaminase (R = 0.37, P = 0.0006) and triglyceride (R = 0.34, P = 0.001) levels in male subjects with metabolic syndrome.
In a Chinese community-dwelling population, prevalence of Mets and its components (including central obesity and high TG) increased with an elevation in serum ALT levels within normal range in both non-drinkers and drinkers, while cfPWV and other components of Mets, such as high blood pressure and glucose, increased with an elevation in serum ALT levels in non-drinkers, but not in drinkers.