Research Article Details

Article ID: A05652
PMID: 33172399
Source: BMC Nephrol
Title: Elevated alanine aminotransferase and low aspartate aminotransferase/alanine aminotransferase ratio are associated with chronic kidney disease among middle-aged women: a cross-sectional study.
Abstract: BACKGROUND: Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) to ALT ratio (AST/ALT ratio) have been shown to be related to non-alcoholic fatty liver disease or insulin resistance, which was associated with chronic kidney disease (CKD). However, it is unclear whether ALT and AST/ALT ratio are associated with CKD. In this study, we examined the relationship of ALT and AST/ALT ratio to CKD among middle-aged females in Japan. METHODS: The present study included 29,133 women aged 40 to 64&#8201;years who had an annual health checkup in Japan during April 2013 to March 2014. Venous blood samples were collected to measure ALT, AST, gamma-glutamyltransferase (GGT), and creatinine levels. In accordance with previous studies, ALT >&#8201;40&#8201;U/L and GGT&#8201;>&#8201;50&#8201;U/L were determined as elevated, AST/ALT ratio&#8201;<&#8201;1 was regarded as low, and CKD was defined as estimated glomerular filtration rate&#8201;<&#8201;60&#8201;mL/min/1.73&#8201;m2 and/or proteinuria. Logistic regression model was used to calculate the odds ratio (OR) and 95% confidence interval (CI) for CKD. RESULTS: "Elevated ALT and elevated GGT" and "elevated ALT and non-elevated GGT" significantly increased the OR for CKD when compared with "non-elevated ALT and non-elevated GGT" (OR: 2.56, 95% CI: 2.10-3.12 and OR: 2.24, 95% CI: 1.81-2.77). Compared with "AST/ALT ratio &#8805; 1 and non-elevated GGT", "AST/ALT ratio < 1 and elevated GGT" and "AST/ALT ratio < 1 and non-elevated GGT" significantly increased the OR for CKD (OR: 2.73, 95% CI: 2.36-3.15 and OR: 1.68, 95% CI: 1.52-1.87). These findings still remained after adjustment for confounders. CONCLUSIONS: Elevated ALT was associated with CKD regardless of GGT elevation. Moreover, low AST/ALT ratio was also associated with CKD independent of GGT elevation.
DOI: 10.1186/s12882-020-02144-6