Relationships between alanine aminotransferase levels, abnormal liver echogenicity, and metabolic syndrome

Abstract

Background: Elevated alanine aminotransferase (e-ALT) and abnormal liver echogenicity (ab-echo), as determined by sonography, have been linked to metabolic syndrome (MetS). However, which of these is more closely related to MetS, especially among older men, remains unknown. Methods: Data from 3065 men aged 65 years or older who were undergoing a routine health examination and who were not taking any medications for MetS were analyzed retrospectively. The patients were divided into 4 groups: group N (n = 1228; patients have normal ALT and liver echogenicity); group A (n = 110; patients have e-ALT but normal liver echogenicity); group E (n = 1381; patients have ab-echo but normal ALT); group AE (n = 346; patients have both e-ALT and ab-echo). Results: Among the 3065 subjects, 714 participants were found to have MetS (23.3%). It is not surprising that MetS components were highest in group AE. More interestingly, compared with group A, group E had higher levels of MetS components (except that high-density lipoprotein cholesterol levels were lower). Similar findings were confirmed by logistic regression. Group E had a significantly higher odds ratio of having MetS than group A (2.73; 95% CI, 1.565-4.763). Conclusions: Our data confirm that both e-ALT and ab-echo are related to a higher incidence of MetS among Taiwanese older men. Of these 2 abnormalities, ab-echo seems to be more closely related to MetS. Further studies are needed to elucidate the complex relationships between these factors in other age and ethnic groups.