Temporal Changes of Liver Function Tests in Relation to Adiposity in the Community: The CoLaus|PsyCoLaus Study

Liver function test (LFT; including alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transferase, and alkaline phosphatase) results are modulated by multiple factors, but their temporal changes have been insufficiently explored, especially in relation to aging and adiposity. First, we assessed the trends of LFTs levels over time across different age groups and sexes. Second, we tested the cross-sectional and longitudinal associations between levels of LFTs and anthropometric measurements capturing various degree of adiposity.

5171 participants (2393 males), aged 35-75 years at baseline (2003-2006), from a prospective population-based cohort (CoLaus|PsyCoLaus study), were included and followed up until 2019-2023. Anthropometric measurements included body mass index, waist-to-height ratio, waist-to-hip ratio, relative fat mass, body shape index, body roundness index, waist-to-weight ratio and body surface area. Boxplots presented changes of LFTs across age groups. Multiple linear regressions and multilevel mixed models were used to analyze the cross-sectional and longitudinal associations between levels of LFTs and anthropometric measurements, adjusting for a large range of variables.

LFTs values showed distinct temporal changes between age groups and sexes. Anthropometric measurements capturing various degree of adiposity demonstrated a strong and significant association (p<0.001) with all four LFTs in both cross-sectional and longitudinal analyses. These associations remained robust even after adjusting for multiple covariates.

In a population-based study, LFTs changed over time according to age and sex. These changes were independently associated with markers of adiposity, showing the importance of interpreting LFTs based on the clinical context, especially in presence of overweight or obesity.