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CLC number: R544.1

On-line Access: 2013-07-30

Received: 2012-11-26

Revision Accepted: 2013-06-03

Crosschecked: 2013-07-19

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Citations:  Bibtex RefMan EndNote GB/T7714

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Journal of Zhejiang University SCIENCE B 2013 Vol.14 No.8 P.743-748

http://doi.org/10.1631/jzus.B1200330


Factors underlying the association of body mass index with serum ALT in Chinese hypertensive adults without known hepatic diseases


Author(s):  Yan Zhang, Xian-hui Qin, Jian-ping Li, Yi-min Cui, Ze-yuan Liu, Zhi-gang Zhao, Jun-bo Ge, De-ming Guan, Jian Hu, Yan-ni Wang, Fu-min Zhang, Xin Xu, Xi-ping Xu, Yong Huo

Affiliation(s):  Department of Cardiology, Peking University First Hospital, Beijing 100034, China; more

Corresponding email(s):   huoyong@263.net.cn

Key Words:  Alanine aminotransferase (ALT), Body mass index (BMI), Waist circumference (WC), Folate


Yan Zhang, Xian-hui Qin, Jian-ping Li, Yi-min Cui, Ze-yuan Liu, Zhi-gang Zhao, Jun-bo Ge, De-ming Guan, Jian Hu, Yan-ni Wang, Fu-min Zhang, Xin Xu, Xi-ping Xu, Yong Huo. Factors underlying the association of body mass index with serum ALT in Chinese hypertensive adults without known hepatic diseases[J]. Journal of Zhejiang University Science B, 2013, 14(8): 743-748.

@article{title="Factors underlying the association of body mass index with serum ALT in Chinese hypertensive adults without known hepatic diseases",
author="Yan Zhang, Xian-hui Qin, Jian-ping Li, Yi-min Cui, Ze-yuan Liu, Zhi-gang Zhao, Jun-bo Ge, De-ming Guan, Jian Hu, Yan-ni Wang, Fu-min Zhang, Xin Xu, Xi-ping Xu, Yong Huo",
journal="Journal of Zhejiang University Science B",
volume="14",
number="8",
pages="743-748",
year="2013",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B1200330"
}

%0 Journal Article
%T Factors underlying the association of body mass index with serum ALT in Chinese hypertensive adults without known hepatic diseases
%A Yan Zhang
%A Xian-hui Qin
%A Jian-ping Li
%A Yi-min Cui
%A Ze-yuan Liu
%A Zhi-gang Zhao
%A Jun-bo Ge
%A De-ming Guan
%A Jian Hu
%A Yan-ni Wang
%A Fu-min Zhang
%A Xin Xu
%A Xi-ping Xu
%A Yong Huo
%J Journal of Zhejiang University SCIENCE B
%V 14
%N 8
%P 743-748
%@ 1673-1581
%D 2013
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1200330

TY - JOUR
T1 - Factors underlying the association of body mass index with serum ALT in Chinese hypertensive adults without known hepatic diseases
A1 - Yan Zhang
A1 - Xian-hui Qin
A1 - Jian-ping Li
A1 - Yi-min Cui
A1 - Ze-yuan Liu
A1 - Zhi-gang Zhao
A1 - Jun-bo Ge
A1 - De-ming Guan
A1 - Jian Hu
A1 - Yan-ni Wang
A1 - Fu-min Zhang
A1 - Xin Xu
A1 - Xi-ping Xu
A1 - Yong Huo
J0 - Journal of Zhejiang University Science B
VL - 14
IS - 8
SP - 743
EP - 748
%@ 1673-1581
Y1 - 2013
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B1200330


Abstract: 
Objective: High body mass index (BMI) is considered as the most important risk factor for elevated serum alanine aminotransferase (ALT) concentration. This study examined an array of factors, including waist circumference (WC) and folate deficiency, which may mediate the association of BMI with serum ALT concentration in Chinese hypertensive adults without known hepatic diseases. Methods: A multicenter, cross-sectional study was carried out. A total of 378 patients with mild or moderate hypertension and without known hepatic diseases were recruited from five hospitals in Harbin, Shanghai, Beijing, Xi’an, and Nanjing. Results: Of the 360 hypertensive patients with complete data in our final analysis, 13.6% had high ALT concentrations (>40 IU/L). Factors including BMI, WC, triglyceride level, and folate concentration were associated with ALT concentration in univariate analysis. Consistently higher prevalence rates of elevated ALT were observed in subjects with lower folate concentrations (≥12 vs. <12 nmol/L, 9.9% vs. 17.8%, P=0.03), with higher BMI (≥28 vs. <28 kg/m2, 21.5% vs. 11.4%, P=0.02) or higher WC (≥90 vs. <90 cm, 18.5% vs. 10.0%, P=0.02). However, in multivariate analysis, the association between BMI and ALT concentration disappeared (P=0.802 in males and 0.369 in females), while WC in females (P<0.001) and folate concentration (P=0.036 in males and 0.044 in females) remained as significant predictors for ALT concentration. Conclusions: This multicenter study demonstrated that WC and low folate concentration were important factors underlying the association between BMI and ALT concentrations in Chinese hypertensive adults without known hepatic diseases.

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

Reference

[1]Angulo, P., 2002. Nonalcoholic fatty liver disease. N. Engl. J. Med., 346(16):1221-1231.

[2]Antoniades, C., Shirodaria, C., Leeson, P., Baarholm, O.A., Van-Assche, T., Cunnington, C., Pillai, R., Ratnatunga, C., Tousoulis, D., Stefanadis, C., et al., 2009. MTHFR 677 C>T polymorphism reveals functional importance for 5-methyltetrahydrofolate, not homocysteine, in regulation of vascular redox state and endothelial function in human atherosclerosis. Circulation, 119(18):2507-2515.

[3]Björck, J., Hellgren, M., Råstam, L., Lindblad, U., 2006. Associations between serum insulin and homocysteine in a Swedish population—a potential link between the metabolic syndrome and hyperhomocysteinemia: the Skaraborg project. Metabolism, 55(8):1007-1013.

[4]Feng, Y., Hong, X., Li, Z., Zhang, W., Jin, D., Liu, X., Zhang, Y., Hu, F.B., Wei, L.J., Zang, T., et al., 2006. Prevalence of metabolic syndrome and its relation to body composition in a Chinese rural population. Obesity, 14(11):2089-2098.

[5]Forman, J.P., Rimm, E.B., Stampfer, M.J., Curhan, G.C., 2005. Folate intake and the risk of incident hypertension among US women. JAMA, 293(3):320-329.

[6]Goessling, W., Massaro, J.M., Vasan, R.S., D′Agostino, R.B.Sr., Ellison, R.C., Fox, C.S., 2008. Aminotransferase levels and 20-year risk of metabolic syndrome, diabetes, and cardiovascular disease. Gastroenterology, 135(6):1935-1944.

[7]Kern, P.A., Ranganathan, S., Li, C., Wood, L., Ranganathan, G., 2001. Adipose tissue tumor necrosis factor and interleukin-6 expression in human obesity and insulin resistance. Am. J. Physiol. Endocrinol. Metab., 280(5):E745-E751.

[8]Kim, H.C., Nam, C.M., Jee, S.H., Han, K.H., Oh, D.K., Sun, I., 2004. Normal serum aminotransferase concentration and risk of mortality from liver diseases: prospective cohort study. BMJ, 328(7446):983-988.

[9]Kim, H.C., Kang, D.R., Nam, C.M., Hur, N.W., Shim, J.S., Jee, S.H., Suh, I., 2005. Elevated serum aminotransferase level as a predictor of intracerebral hemorrhage: Korea medical insurance corporation study. Stroke, 36(8):1642-1647.

[10]Kim, J., Jo, I., 2010. Relationship between body mass index and alanine aminotransferase concentration in non-diabetic Korean adults. Eur. J. Clin. Nutr., 64(2):169-175.

[11]Lee, D.H., Ha, M.H., Christiani, D.C., 2001. Body weight, alcohol consumption and liver enzyme activity—a 4-year follow-up study. Int. J. Epidemiol., 30(4):766-770.

[12]Oh, S.Y., Cho, Y.K., Kang, M.S., Yoo, T.W., Park, J.H., Kim, H.J., Park, D.I., Sohn, C.I., Jeon, W.K., Kim, B.I., et al., 2006. The association between increased alanine aminotransferase activity and metabolic factors in nonalcoholic fatty liver disease. Metabolism, 55(12):1604-1609.

[13]Park, H.S., Han, J.H., Choi, K.M., Kim, S.M., 2005. Relation between elevated serum alanine aminotransferase and metabolic syndrome in Korean adolescents. Am. J. Clin. Nutr., 82(5):1046-1051.

[14]Purohit, V., Abdelmalek, M.F., Barve, S., Benevenga, N.J., Halsted, C.H., Kaplowitz, N., Kharbanda, K.K., Liu, Q.Y., Lu, S.C., McClain, C.J., et al., 2007. Role of S-adenosylmethionine, folate, and betaine in the treatment of alcoholic liver disease: summary of a symposium. Am. J. Clin. Nutr., 86(1):14-24.

[15]Qin, X., Li, J., Cui, Y., Liu, Z., Zhao, Z., Ge, J., Guan, D., Hu, J., Wang, Y., Zhang, F., et al., 2012a. Effect of folic acid intervention on ALT concentration in hypertensives without known hepatic disease: a randomized, double-blind, controlled trial. Eur. J. Clin. Nutr., 66(5):541-548.

[16]Qin, X., Li, J., Cui, Y., Liu, Z., Zhao, Z., Ge, J., Guan, D., Hu, J., Wang, Y., Zhang, F., et al., 2012b. Effect of folic acid intervention on the change of serum folate level in hypertensive Chinese adults: do methylenetetrahydrofolate reductase and methionine synthase gene polymorphisms affect therapeutic responses? Pharmacogenet. Genom., 22(6):421-428.

[17]Qin, X., Li, J., Cui, Y., Liu, Z., Zhao, Z., Ge, J., Guan, D., Hu, J., Wang, Y., Zhang, F., et al., 2012c. MTHFR C677T and MTR A2756G polymorphisms and the homocysteine lowering efficacy of different doses of folic acid in hypertensives Chinese adults. Nutr. J., 11:2.

[18]Ruhl, C.E., Everhart, J.E., 2003. Determinants of the association of overweight with elevated serum alanine aminotransferase activity in the United States. Gastroenterology, 124(1):71-79.

[19]Salvaggio, A., Periti, M., Miano, L., Tavanelli, M., Marzorati, D., 1991. Body mass index and liver enzyme activity in serum. Clin. Chem., 37(5):720-723.

[20]Schindhelm, R.K., Dekker, J.M., Nijpels, G., Bouter, L.M., Stehouwer, C.D., Heine, R.J., Diamant, M., 2007. Alanine aminotransferase predicts coronary heart disease events: a 10-year follow-up of the Hoorn Study. Atherosclerosis, 191(2):391-396.

[21]Shen, L., Fan, J.G., Shao, Y., Zeng, M.D., Wang, J.R., Luo, G.H., Li, J.Q., Chen, S.Y., 2003. Prevalence of nonalcoholic fatty liver among administrative officers in Shanghai: an epidemiological survey. World J. Gastroenterol., 9(5):1106-1110.

[22]Sull, J.W., Yun, J.E., Lee, S.Y., Ohrr, H., Jee, S.H., Guallar, E., Samet, J.M., 2009. Body mass index and serum aminotransferase levels in Korean men and women. J. Clin. Gastroenterol, 43(9):869-875.

[23]Tamura, S., Shimomura, I., 2005. Contribution of adipose tissue and de novo lipogenesis to nonalcoholic fatty liver disease. J. Clin. Invest., 115(5):1139-1142.

[24]Verhaar, M.C., Stroes, E., Rabelink, T.J., 2002. Folates and cardiovascular disease. Arterioscler. Thromb. Vasc. Biol., 22(1):6-13.

[25]Wald, D.S., Law, M., Morris, J.K., 2002. Homocysteine and cardiovascular disease: evidence on causality from a meta-analysis. BMJ, 325(7374):1202-1206.

[26]Welzel, T.M., Katki, H.A., Sakoda, L.C., Evans, A.A., London, W.T., Chen, G., O′Broin, S., Shen, F.M., Lin, W.Y., McGlynn, K.A., 2007. Blood folate levels and risk of liver damage and hepatocellular carcinoma in a prospective high-risk cohort. Cancer Epidemiol. Biomarkers Prev., 16(6):1279-1282.

[27]Yang, Q., Botto, L.D., Erickson, J.D., Berry, R.J., Sambell, C., Johansen, H., Friedman, J.M., 2006. Improvement in stroke mortality in Canada and the United States, 1990 to 2002. Circulation, 113(10):1335-1343.

[28]Yun, K.E., Shin, C.Y., Yoon, Y.S., Park, H.S., 2009. Elevated alanine aminotransferase levels predict mortality from cardiovascular disease and diabetes in Koreans. Atherosclerosis, 205(2):533-537.

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