Alanine aminotransferase is associated with atherothrombotic risk factors in a British South Asian population

Alanine aminotransferase (ALT) predicts the development of Type 2 diabetes mellitus and cardiovascular disease in Caucasian subjects.

This study aimed to determine the incidence of an elevated ALT and its relationship to metabolic and atherothrombotic risk factors in a healthy British South Asian population.

One hundred and forty-three participants from the West Yorkshire community were recruited randomly from general practice registers and were grouped according to whether their ALT was above or within the normal range (cut-off 35 IU L(-1)) and examined for differences in metabolic and atherothrombotic risk factors. All participants were originally from South Asia, with their grandparents being born in India, Pakistan, or Bangladesh.

The incidence of a raised ALT was 24%. Those with a raised ALT had a more adverse metabolic profile, with significantly higher body mass index, waist/hip ratio, fasting insulin, glucose, homeostasis model assessment homeostasis model assessment insulin resistance (HOMA-IR), and triglycerides, and lower high-density lipoprotein (HDL) cholesterol. Fifty per cent had the metabolic syndrome [International Diabetes Federation (IDF) criteria]. They also had a more adverse atherothrombotic profile, with higher tissue-type plasminogen activator and plasminogen activator inhibitor-1 (PAI-1) antigen. In accordance, the group as a whole showed a positive correlation of ALT (age-adjusted) with waist/hip ratio, insulin, glucose, triglycerides, PAI-1 antigen, factor XIII B subunit, and FXII, and a negative correlation with HDL cholesterol.

Raised ALT is common in apparently healthy British South Asians, and is significantly associated with an adverse metabolic and atherothrombotic risk profile.