Relationships between alanine aminotransferase levels, abnormal liver echogenicity, and metabolic syndrome

Elevated alanine aminotransferase (e-ALT) and abnormal liver echogenicity (ab-echo), as determined by sonography, have been linked to metabolic syndrome (MetS). However, which of these is more closely related to MetS, especially among older men, remains unknown.

Data from 3065 men aged 65 years or older who were undergoing a routine health examination and who were not taking any medications for MetS were analyzed retrospectively. The patients were divided into 4 groups: group N (n= 1228; patients have normal ALT and liver echogenicity); group A (n=110; patients have e-ALT but normal liver echogenicity); group E (n=1381; patients have ab-echo but normal ALT); group AE (n=346; patients have both e-ALT and ab-echo).

Among the 3065 subjects, 714 participants were found to have MetS (23.3%). It is not surprising that MetS components were highest in group AE. More interestingly, compared with group A, group E had higher levels of MetS components (except that high-density lipoprotein cholesterol levels were lower). Similar findings were confirmed by logistic regression. Group E had a significantly higher odds ratio of having MetS than group A (2.73; 95% CI, 1.565-4.763).

Our data confirm that both e-ALT and ab-echo are related to a higher incidence of MetS among Taiwanese older men. Of these 2 abnormalities, ab-echo seems to be more closely related to MetS. Further studies are needed to elucidate the complex relationships between these factors in other age and ethnic groups.