Faculty Collaboration Database

Age impacts ability of aspartate-alanine aminotransferase ratio to predict advanced fibrosis in nonalcoholic Fatty liver disease. Dig Dis Sci 2015 Jun;60(6):1825-31

Date

02/25/2015

Pubmed ID

25708897

DOI

10.1007/s10620-015-3529-8

Scopus ID

2-s2.0-84930376071 (requires institutional sign-in at Scopus site)   17 Citations

Abstract

BACKGROUND AND AIM: While histological differences have been reported between pediatric and adult nonalcoholic fatty liver disease (NAFLD), potential age-related changes in serum transaminases and liver histology remain largely unexplored. Our study sought to investigate the clinical and histological characteristics of NAFLD across age.

METHODS: This was a prospective cross-sectional study of 502 biopsy-proven NAFLD patients. Clinical data were evaluated and compared among different age groups; group A (ages 18-44), B (ages 45-64), and C (≥ ages 65).

RESULTS: 34.9, 56.0, and 9.1 % of the cohort were distributed among group A, B, and C, respectively. While the prevalence of nonalcoholic steatohepatitis (NASH) was comparable across age groups, the prevalence of advanced fibrosis increased with age (p = 0.000). Although the mean ALT progressively decreased with age; 87, 64, 56 U/L in group A, B, and C, respectively (p = 0.000), there was no difference in mean AST (p = 0.939) across age. The AST:ALT ratio (AAR) progressively increased from 0.7, 0.9, and 1.1 in group A, B, and C, respectively (p = 0.000). In group C, an AAR ≥ 1 was found in 74 and 40 % of patients with and without advanced fibrosis.

CONCLUSION: With advancing age, ALT levels progressively declined while AST levels remained stable, leading to a higher AAR. Although higher AAR is often used as a surrogate measure of advanced fibrosis, advancing age can also contribute to increased AAR. In fact, an AAR ≥ 1 was found in significant number of elderly patients without advanced fibrosis. Consequently, an increased AAR may be a function of decreasing ALT with age in addition to progressive fibrosis.

Author List

Goh GB, Pagadala MR, Dasarathy J, Unalp-Arida A, Pai RK, Yerian L, Khiyami A, Sourianarayanane A, Sargent R, Hawkins C, Dasarathy S, McCullough AJ

Author

Achuthan Sourianarayanane MD Associate Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Age Factors
Aged
Alanine Transaminase
Aspartate Aminotransferases
Biomarkers
Biopsy
Cross-Sectional Studies
Female
Humans
Liver Cirrhosis
Liver Function Tests
Male
Middle Aged
Non-alcoholic Fatty Liver Disease
Predictive Value of Tests
Prevalence
Prospective Studies
Risk Factors