Alanine aminotransferase decreases with age: the Rancho Bernardo Study |
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Authors: | Dong Mamie H Bettencourt Ricki Barrett-Connor Elizabeth Loomba Rohit |
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Affiliation: | Division of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, California, United States of America. |
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Abstract: | BackgroundSerum alanine aminotransferase (ALT) is a marker of liver injury. The 2005 American Gastroenterology Association Future Trends Committee report states that serum ALT levels remain constant with age. This study examines the association between serum ALT and age in a community-dwelling cohort in the United States.MethodsA cross-sectional study of 2,364 (54% female) participants aged 30–93 years from the Rancho Bernardo Study cohort who attended a research clinic visit in 1984–87. Demographic, metabolic co-variates, ALT, bilirubin, gamma glutamyl transferase (GGT), albumin, and adiposity signaling biomarkers (leptin, IL-6, adiponectin, ghrelin) were measured. Participants were divided into four-groups based upon age quartile, and multivariable-adjusted least squares of means (LSM) were examined (p for trend <0.05).ResultsALT decreased with increasing age, with mean ALT levels (IU/L) of 23, 21, 20, and 17 for those between quartile ages 30–62, 63–71, 72–77, and 78–93 years (p<0.0001). Trends of decreasing LSM ALT with age and the decreasing prevalence of categorically defined elevated serum ALT with age remained robust after adjusting for sex, alcohol use, metabolic syndrome components, and biomarkers of adiposity (p-value <0.0001), and was not materially changed after adjusting for bilirubin, GGT, and albumin.ConclusionsALT levels decrease with age in both men and women independent of metabolic syndrome components, adiposity signaling biomarkers, and other commonly used liver function tests. Further studies are needed to understand the mechanisms responsible for a decline in ALT with age, and to establish the optimal cut-point of normal ALT in the elderly. |
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