@article{ref1,
title="Low ALT blood levels predict long-term all-cause mortality among adults. A historical prospective cohort study",
journal="European journal of internal medicine",
year="2014",
author="Ramaty, E. and Maor, E. and Peltz-Sinvani, N. and Brom, A. and Grinfeld, A. and Kivity, S. and Segev, S. and Sidi, Y. and Kessler, T. and Sela, B. A. and Segal, G.",
volume="25",
number="10",
pages="919-921",
abstract="BACKGROUND: Increased blood levels of alanine amino transferase (ALT, also known as SGPT; serum glutamic pyruvic transaminase) serve as a marker of liver injury by various mechanisms. Less is known about the clinical implications associated with low-normal ALT levels. Previous studies showed low ALT levels to be associated with poor long-term outcomes among elderlies, serving as a biomarker for increased incidence of frailty and subsequent risk of mortality. However, it has not been determined yet whether low-normal ALT values might be predictive of frailty and mortality in younger, middle-aged adults. <br><br>METHODS: We conducted a historical prospective cohort analysis. <br><br>RESULTS: A total of 23,506 adults with ALT levels within the normal range, at the mean age of 48±11years, participating in an annual screening program for preventive medicine, were followed-up for a median period of 8.5years during which 638 died. Low-normal ALT values (serum ALT activity <17IU/L) were found to be predictive for increased risk of all-cause mortality (HR=1.6; 95% CI 1.34-1.92; p<0.001). Statistically significant correlation was demonstrated even after applying a multifactorial model correction for age, gender, eGFR, low albumin, arterial hypertension, diabetes mellitus and ischemic heart disease. <br><br>CONCLUSIONS: We suggest that low-normal ALT values may serve as an independent predictive marker for increased long-term mortality in middle-aged adults.<p /><p>Language: en</p>",
language="en",
issn="0953-6205",
doi="10.1016/j.ejim.2014.10.019",
url="http://dx.doi.org/10.1016/j.ejim.2014.10.019"
}