Persistent alanine aminotransferase elevation among the general Iranian population: prevalence and causes

• Published in: World journal of gastroenterology : WJG Vol. 14; no. 18; pp. 2867 - 2871
• Main Authors: Jamali, Raika, Khonsari, Mahmoodreza, Merat, Shahin, Khoshnia, Masoud, Jafari, Elham, Bahram Kalhori, Alireza, Abolghasemi, Hassan, Amini, Sedighe, Maghsoudlu, Mahtab, Deyhim, Mohammad-Reza, Rezvan, Houri, Pourshams, Akram
• Format: Journal Article
• Language: English
• Published: United States Digestive Disease Research Center, Shariati Hospital, Medical Sciences/University of Tehran, Tehran 14117, Iran Mahmoodreza Khonsari, Department of Internal Medicine Hamadan, Hamadan University of Medical Sciences, Iran%Department of Internal Medicine Hamadan,Hamadan University of Medical Sciences,Iran%Department of Radiology Gonbad,Social Insurance Organization Khatam Hospital, Golestan, Iran%Iranian Blood Transfusion Research Center, Tehran 14117, Iran 14-05-2008; The WJG Press and Baishideng
• Subjects: Adolescent; Adult; Aged; Alanine Transaminase - blood; Biomarkers - blood; Fatty Liver - blood; Fatty Liver - epidemiology; Fatty Liver - ethnology; Female; Hepatitis B - blood; Hepatitis B - epidemiology; Hepatitis B - ethnology; Hepatitis C - blood; Hepatitis C - epidemiology; Hepatitis C - ethnology; Humans; Iran - epidemiology; Male; Middle Aged; Prevalence; Rapid Communication; Iran; Viral hepatitis; Alanine aminotransferase; Iran; Non-alcoholic fatty liver disease
• ISSN: 1007-9327
• DOI: 10.3748/wjg.14.2867

To determine the prevalence and causes of persistently elevated alanine aminotransferase (ALT) levels among the general population in northern Iran.
A total of 2292 (1376 female, aged 18-75 year), were selected by systematic clustered random sampling from the cities and villages of Gonbad and Kalaleh in Golestan Province and invited to participate in the study. A comprehensive history regarding alcohol drinking and medication was taken. Body mass index (BMI), viral markers and ALT levels were measured. If ALT level was > or = 40 U/L, it was rechecked twice within 6 mo. Those with > or = 2 times elevation of ALT were considered as having persistently elevated ALT level. Non-alcoholic fatty liver disease (NAFLD) was diagnosed based on evidence of fatty liver upon sonography and excluding other etiology.
A total of 2049 (1351 female) patients participated in the study, 162 (7.9%) had elevated ALT level at the first measurement. Persistently elevated ALT level was detected in 64 (3.1%) participants, with 51 (79.6%) with no obvious etiology, six (9.3%) with Hepatitis B, four (6.2%) with Hepatitis C virus (HCV) infection and three (4.6%) with alcoholic hepatitis. The prevalence of NAFLD and alcoholic hepatitis was 2.04% (42 patients) and 0.1% (three), respectively. There was correlation between NAFLD and male gender, overweight, diabetes and living in an urban area [odds ratio = 3.03 (95% CI: 1.6-5.72), 4.21 (95% CI: 1.83-9.68), 2.86 (95% CI: 1.05-7.79) and 2.04 (95% CI: 1.00-4.16) respectively].
NAFLD is the most common cause of persistently elevated serum ALT level among the general population of Iran.