Low ALT values amongst hospitalized patients are associated with increased risk of hypoglycemia and overall mortality: a retrospective, big-data analysis of 51 831 patients

Summary Background Sarcopenia and frailty influence clinical patients’ outcomes. Low alanine aminotransferase (ALT) serum activity is a surrogate marker for sarcopenia and frailty. In-hospital hypoglycemia is associated, also with worse clinical outcomes. Aim We evaluated the association between low...

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Bibliographic Details
Published in:	QJM : An International Journal of Medicine Vol. 114; no. 12; pp. 843 - 847
Main Authors:	Itelman, E, Segev, A, Ahmead, L, Leibowitz, E, Agbaria, M, Avaky, C, Negro, L, Shenhav-Saltzman, G, Wasserstrum, Y, Segal, G
Format:	Journal Article
Language:	English
Published:	England Oxford University Press 09-01-2022
Subjects:	Aged Alanine Transaminase - analysis Data Analysis Frailty Humans Hypoglycemia - epidemiology Mortality Retrospective Studies Risk Factors
Online Access:	Get full text
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Summary:	Summary Background Sarcopenia and frailty influence clinical patients’ outcomes. Low alanine aminotransferase (ALT) serum activity is a surrogate marker for sarcopenia and frailty. In-hospital hypoglycemia is associated, also with worse clinical outcomes. Aim We evaluated the association between low ALT, risk of in-hospital hypoglycemia and subsequent mortality. Design This was a retrospective cohort analysis. Methods We included patients hospitalized in a tertiary hospital between 2007 and 2019. Patients’ data were retrieved from their electronic medical records. Results The cohort included 51 831 patients (average age 70.88). The rate of hypoglycemia was 10.8% (amongst diabetics 19.4% whereas in non-diabetics 8.3%). The rate of hypoglycemia was higher amongst patients with ALT < 10 IU/l in the whole cohort (14.3% vs. 10.4%, P < 0.001) as well as amongst diabetics (24.6% vs. 18.8%, P < 0.001). Both the overall and in-hospital mortality were higher in the low ALT group (57.7% vs. 39.1% P < 0.001 and 4.3% vs. 3.2%, P < 0.001). A propensity score matching, after which a regression model was performed, showed that patients with ALT levels < 10 IU/l had higher risk of overall mortality (HR = 1.21, CI 1.13–1.29, P < 0.001). Conclusions Low ALT values amongst hospitalized patients are associated with increased risk of in-hospital hypoglycemia and overall mortality.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1460-2725 1460-2393
DOI:	10.1093/qjmed/hcaa219