PDF(Pubmed)
Abstract：
Alanine aminotransferase (ALT) serum levels increase because of hepatocellular damage. Metabolic dysfunction-associated fatty liver disease (MAFLD), which identifies steatotic liver disease (SLD) associated with ≥ 2 metabolic abnormalities, has prominent sexual differences. The Metabolic Syndrome defines a cluster comprising abdominal obesity, altered glucose metabolism, dyslipidemia, and hypertension. Male sex, body mass index, glucose, lipids, ferritin, hypertension, and age independently predict ALT levels among blood donors. Over the last few decades, the reference range of ALT levels has been animatedly debated owing to attempts to update sex-specific reference ranges. With this backset, Chen et al have recently published a study which has two main findings. First, > 80% of individuals with MAFLD had normal ALT levels. Second, there was a linear increasing trend in the association between cumulative excess high-normal ALT levels and the rate of incident MAFLD. This study has biologically credible findings. However, it inaccurately considered sex differences in the MAFLD arena. Therefore, future studies on SLD owing to metabolic dysfunction should adopt locally determined and prospectively validated reference ranges of ALT and carefully consider sex differences in liver enzymes and MAFLD pathobiology.
摘要：
丙氨酸氨基转移酶（ALT）血清水平由于肝细胞损伤而升高。代谢功能障碍相关脂肪性肝病（MAFLD），确定与≥2代谢异常相关的脂肪变性肝病（SLD），有明显的性别差异。代谢综合征定义了一个包括腹部肥胖的集群，改变葡萄糖代谢，血脂异常,和高血压。男性,身体质量指数,葡萄糖，脂质，铁蛋白,高血压,和年龄独立预测献血者的ALT水平。在过去的几十年里，由于试图更新特定性别的参考范围,人们对ALT水平的参考范围进行了激烈的争论.有了这个倒退，Chen等人最近发表了一项研究，其中有两个主要发现。首先,>80%的MAFLD患者ALT水平正常。第二,ALT累积过量高正常值水平与MAFLD发生率之间呈线性增加趋势.这项研究有生物学上可信的发现。然而,它不准确地考虑了MAFLD领域的性别差异。因此,未来关于代谢功能障碍导致的SLD的研究应采用局部确定和前瞻性验证的ALT参考范围,并仔细考虑肝酶和MAFLD病理学的性别差异.
