ALT Levels for Asians With Metabolic Diseases: A Meta-analysis of 86 Studies With Individual Patient Data Validation

doi:10.1002/hep4.1593

中山醫學大學機構典藏 CSMUIR > 中山醫學大學研究成果 > 期刊論文 > Item 310902500/24923

Please use this identifier to cite or link to this item: https://ir.csmu.edu.tw:8080/ir/handle/310902500/24923

Title:	ALT Levels for Asians With Metabolic Diseases: A Meta-analysis of 86 Studies With Individual Patient Data Validation
Authors:	Huang, DQ;Yeo, YH;Tan, E;Takahashi, H;Yasuda, S;Saruwatari, J;Tanaka, K;Oniki, K;Kam, LY;Muthiah, MD;Hyogo, H;Ono, M;Barnett, SD;Li, J;Zou, BY;Fung, J;Lee, TY;Wong, VWS;Yuen, MF;Dan, YY;Lim, SG;Cheung, R;Toyoda, H;Eguchi, Y;Nguyen, MH
Date:	2020
Issue Date:	2022-08-09T08:10:13Z (UTC)
Publisher:	JOHN WILEY & SONS LTD
Abstract:	The current alanine aminotransferase (ALT) upper limit of normal was defined using selected healthy Caucasian blood donors. Given the global rise in obesity and different body habitus in Asians, we aimed to perform a systematic review and meta-analysis combined with bootstrap modeling and individual patient data validation to estimate the ALT upper threshold for Asians, including the overweight and diabetics. We included studies from PubMed, Embase, and Cochrane database searches that identified individuals without known liver diseases (i.e., viral hepatitis, alcohol, and ultrasound-detected nonalcoholic fatty liver disease). The mean ALT (U/L) was estimated using a random-effects mixed model and upper threshold (95th-percentile value, U/L) via a bootstrap model with 10,000 resamples. We screened 4,995 studies and identified 86 studies that reported ALT values for 526,641 individuals without excessive alcohol intake or known liver diseases, yielding a mean ALT of 19 and ALT upper threshold of 32. The ALT upper threshold was 37 in males versus 31 in females, 39 in overweight versus 28 in normal-weight individuals, and 36 for diabetics versus 33 for nondiabetics. We validated our study level data with individual patient level data in 6,058 individuals from five study centers in Japan. Consistent with our study-level data, we found that the ALT upper threshold in our individual patient data analysis was indeed higher in overweight versus normal-weight individuals (39 vs. 32) and in diabetics versus nondiabetics (42 vs. 33).Conclusion:We provide validated reference ranges for ALT upper threshold derived from Asians without known liver disease, including individuals with ultrasound-detected nonalcoholic fatty liver disease who are normal weight, overweight, nondiabetic, and diabetic, to inform practice.
URI:	http://dx.doi.org/10.1002/hep4.1593 https://www.webofscience.com/wos/woscc/full-record/WOS:000570299500001 https://ir.csmu.edu.tw:8080/handle/310902500/24923
Relation:	HEPATOLOGY COMMUNICATIONS ,2020 ,v4 ,issue 11 ,p1624-1636
Appears in Collections:	[中山醫學大學研究成果] 期刊論文

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