Alanine Aminotransferase Decreases with Age The Rancho Bernardo Study 英文参考文献.docVIP

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Alanine Aminotransferase Decreases with Age The Rancho Bernardo Study 英文参考文献.doc

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Alanine Aminotransferase Decreases with Age The Rancho Bernardo Study 英文参考文献

AlanineAminotransferaseDecreaseswithAge:The RanchoBernardoStudy MamieH.Dong1,RickiBettencourt2,ElizabethBarrett-Connor2,RohitLoomba1,2* 1Division of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, California, United States of America, 2Division of Epidemiology, DepartmentofFamilyandPreventiveMedicine,UniversityofCaliforniaSanDiego,LaJolla,California,UnitedStatesofAmerica Abstract Background: Serum alanine aminotransferase (ALT) is a marker of liver injury. The 2005 American Gastroenterology AssociationFutureTrendsCommitteereportstatesthatserumALTlevelsremainconstantwithage.Thisstudyexaminesthe associationbetweenserumALTandageinacommunity-dwellingcohortintheUnitedStates. Methods: A cross-sectional study of 2,364 (54% female) participants aged 30–93 years from the Rancho Bernardo Study cohortwhoattendedaresearchclinicvisitin1984–87.Demographic,metabolicco-variates,ALT,bilirubin,gammaglutamyl transferase (GGT), albumin, and adiposity signaling biomarkers (leptin, IL-6, adiponectin, ghrelin) were measured. Participants were divided into four-groups based upon age quartile, and multivariable-adjusted least squares of means (LSM)wereexamined(pfortrend,0.05). Results:ALTdecreasedwithincreasingage,withmeanALTlevels(IU/L)of23,21,20,and17forthosebetweenquartile ages 30–62, 63–71, 72–77, and 78–93 years (p,0.0001). Trends of decreasing LSM ALT with age and the decreasing prevalence of categorically defined elevated serum ALT with age remained robust after adjusting for sex, alcohol use, metabolic syndrome components, and biomarkers of adiposity (p-value ,0.0001), and was not materially changed after adjustingforbilirubin,GGT,andalbumin. Conclusions: ALT levels decrease with age in both men and women independent of metabolic syndrome components, adipositysignalingbiomarkers,andothercommonlyusedliverfunctiontests.Furtherstudiesareneededtounderstandthe mechanismsresponsibleforadeclineinALTwithage,andtoestablishtheoptimalcut-pointofnormal