Low ALT blood levels predict long-term all-cause mortality among adults. A historical prospective cohort study

Eur J Intern Med. 2014 Dec;25(10):919-21. doi: 10.1016/j.ejim.2014.10.019. Epub 2014 Oct 30.

Abstract

Background: Increased blood levels of alanine amino transferase (ALT, also known as SGPT; serum glutamic pyruvic transaminase) serve as a marker of liver injury by various mechanisms. Less is known about the clinical implications associated with low-normal ALT levels. Previous studies showed low ALT levels to be associated with poor long-term outcomes among elderlies, serving as a biomarker for increased incidence of frailty and subsequent risk of mortality. However, it has not been determined yet whether low-normal ALT values might be predictive of frailty and mortality in younger, middle-aged adults.

Methods: We conducted a historical prospective cohort analysis.

Results: A total of 23,506 adults with ALT levels within the normal range, at the mean age of 48 ± 11 years, participating in an annual screening program for preventive medicine, were followed-up for a median period of 8.5 years during which 638 died. Low-normal ALT values (serum ALT activity <17IU/L) were found to be predictive for increased risk of all-cause mortality (HR=1.6; 95% CI 1.34-1.92; p<0.001). Statistically significant correlation was demonstrated even after applying a multifactorial model correction for age, gender, eGFR, low albumin, arterial hypertension, diabetes mellitus and ischemic heart disease.

Conclusions: We suggest that low-normal ALT values may serve as an independent predictive marker for increased long-term mortality in middle-aged adults.

Keywords: ALT; Frailty; Mortality; SGPT; Screening; Survival.

MeSH terms

  • Adult
  • Aged
  • Alanine Transaminase / blood*
  • Cohort Studies
  • Female
  • Frail Elderly
  • Humans
  • Male
  • Middle Aged
  • Mortality*
  • Multivariate Analysis
  • Prospective Studies

Substances

  • Alanine Transaminase