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Abstract：
Every distinct liver enzyme biomarker exhibits a strong correlation with non-alcoholic fatty liver disease (NAFLD). This study aims to comprehensively analyze and compare the associations of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT) with NAFLD from a gender perspective.
This study was conducted on 6,840 females and 7,411 males from the NAGALA cohort. Multivariable logistic regression analysis was used to compare the associations between liver enzyme markers and NAFLD in both genders, recording the corresponding adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Receiver operating characteristic (ROC) curves were used to evaluate the accuracy of individual liver enzyme markers and different combinations of them in identifying NAFLD.
Liver enzyme markers ALT, AST, and GGT were all independently associated with NAFLD and exhibited significant gender differences (All P-interaction<0.05). In both genders, ALT exhibited the most significant association with NAFLD, with adjusted standardized ORs of 2.19 (95% CI: 2.01-2.39) in males and 1.60 (95% CI: 1.35-1.89) in females. Additionally, ROC analysis showed that ALT had significantly higher accuracy in identifying NAFLD than AST and GGT in both genders (Delong P-value < 0.05), and the accuracy of ALT in identifying NAFLD in males was higher than that in females [Area under the ROC curve (AUC): male 0.79, female 0.77]. Furthermore, out of the various combinations of liver enzymes, ALT+GGT showed the highest accuracy in identifying NAFLD in both genders, with AUCs of 0.77 (95% CI: 0.75-0.79) in females and 0.79 (95% CI: 0.78-0.81) in males.
Our study revealed significant gender differences in the associations of the three commonly used liver enzyme markers with NAFLD. In both genders, the use of ALT alone may be the simplest and most effective tool for screening NAFLD, especially in males.
This study was conducted on 6,840 females and 7,411 males from the NAGALA cohort. Multivariable logistic regression analysis was used to compare the associations between liver enzyme markers and NAFLD in both genders, recording the corresponding adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Receiver operating characteristic (ROC) curves were used to evaluate the accuracy of individual liver enzyme markers and different combinations of them in identifying NAFLD.
Liver enzyme markers ALT, AST, and GGT were all independently associated with NAFLD and exhibited significant gender differences (All P-interaction<0.05). In both genders, ALT exhibited the most significant association with NAFLD, with adjusted standardized ORs of 2.19 (95% CI: 2.01-2.39) in males and 1.60 (95% CI: 1.35-1.89) in females. Additionally, ROC analysis showed that ALT had significantly higher accuracy in identifying NAFLD than AST and GGT in both genders (Delong P-value < 0.05), and the accuracy of ALT in identifying NAFLD in males was higher than that in females [Area under the ROC curve (AUC): male 0.79, female 0.77]. Furthermore, out of the various combinations of liver enzymes, ALT+GGT showed the highest accuracy in identifying NAFLD in both genders, with AUCs of 0.77 (95% CI: 0.75-0.79) in females and 0.79 (95% CI: 0.78-0.81) in males.
Our study revealed significant gender differences in the associations of the three commonly used liver enzyme markers with NAFLD. In both genders, the use of ALT alone may be the simplest and most effective tool for screening NAFLD, especially in males.
摘要：
■每种不同的肝酶生物标志物表现出非酒精性脂肪性肝病(NAFLD)的强相关性。本研究旨在全面分析和比较丙氨酸转氨酶(ALT)与天冬氨酸转氨酶（AST），和γ-谷氨酰转移酶（GGT）与NAFLD从性别角度。
■这项研究是对来自NAGALA队列的6,840名女性和7,411名男性进行的。多变量logistic回归分析用于比较两种性别的肝酶标志物和NAFLD之间的关联。记录相应的调整后比值比(OR)和95%置信区间(CI)。使用受试者工作特征（ROC）曲线来评估单个肝酶标志物及其不同组合在识别NAFLD中的准确性。
■肝酶标志物ALT，AST,GGT和GGT均与NAFLD独立相关，并表现出显著的性别差异（所有P交互作用<0.05）。在两种性别中，ALT表现出与NAFLD最显著的关联，男性和女性的校正标准OR为2.19（95％CI：2.01-2.39），女性为1.60（95％CI：1.35-1.89）。此外,ROC分析显示，在两种性别中，ALT在识别NAFLD方面的准确性明显高于AST和GGT（DelongP值<0.05），男性ALT识别NAFLD的准确性高于女性[ROC曲线下面积（AUC）：男性0.79，女性0.77]。此外，在肝脏酶的各种组合中，ALT+GGT在两种性别中识别NAFLD的准确性最高，女性AUC为0.77（95％CI：0.75-0.79），男性为0.79（95％CI：0.78-0.81）。
■我们的研究揭示了三种常用的肝酶标记物与NAFLD之间存在显著的性别差异。在两种性别中，单独使用ALT可能是筛查NAFLD的最简单和最有效的工具，尤其是男性。
■这项研究是对来自NAGALA队列的6,840名女性和7,411名男性进行的。多变量logistic回归分析用于比较两种性别的肝酶标志物和NAFLD之间的关联。记录相应的调整后比值比(OR)和95%置信区间(CI)。使用受试者工作特征（ROC）曲线来评估单个肝酶标志物及其不同组合在识别NAFLD中的准确性。
■肝酶标志物ALT，AST,GGT和GGT均与NAFLD独立相关，并表现出显著的性别差异（所有P交互作用<0.05）。在两种性别中，ALT表现出与NAFLD最显著的关联，男性和女性的校正标准OR为2.19（95％CI：2.01-2.39），女性为1.60（95％CI：1.35-1.89）。此外,ROC分析显示，在两种性别中，ALT在识别NAFLD方面的准确性明显高于AST和GGT（DelongP值<0.05），男性ALT识别NAFLD的准确性高于女性[ROC曲线下面积（AUC）：男性0.79，女性0.77]。此外，在肝脏酶的各种组合中，ALT+GGT在两种性别中识别NAFLD的准确性最高，女性AUC为0.77（95％CI：0.75-0.79），男性为0.79（95％CI：0.78-0.81）。
■我们的研究揭示了三种常用的肝酶标记物与NAFLD之间存在显著的性别差异。在两种性别中，单独使用ALT可能是筛查NAFLD的最简单和最有效的工具，尤其是男性。
