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Metabolic markers and ALT cutoff level for diagnosing nonalcoholic fatty liver disease: a community-based cross-sectional study

Journal of Gastroenterology volume 47, pages 696–703 (2012)Cite this article

Abstract

Background

Untreated nonalcoholic fatty liver disease (NAFLD) may progress to liver cirrhosis or failure and is associated with the development of hepatocellular carcinoma, diabetes, and cardiovascular disease. It is therefore essential to diagnose and treat NAFLD at an early stage. To assist in this effort, this retrospective study explored the risk factors for NAFLD, and derived new surrogates, a revised alanine aminotransferase (ALT) cutoff level and a novel NAFLD index, to identify previously undiagnosed cases of NAFLD.

Methods

Using a community-based, cross-sectional design, the records of 6,370 Japanese subjects who had undergone at least 1 annual health check-up were reviewed for the identification of subjects meeting the diagnostic criteria for NAFLD and the variables associated with NAFLD for the estimation of ideal ALT cutoff levels.

Results

The results of multivariate analysis of the 1,346 subjects who met the diagnostic criteria for NAFLD confirmed that metabolic disease markers and a novel NAFLD index, using the variables derived from multivariate analysis, were also markers of NAFLD. The ALT cutoff levels for NAFLD diagnosis were estimated at 25 U/L for males and 17 U/L for females.

Conclusions

ALT level and the novel NAFLD index were confirmed to be surrogate markers for NAFLD in addition to metabolic disease markers. The ALT cutoff level used in NAFLD diagnosis should be revised downward to identify subjects at risk of NAFLD to prevent NAFLD progression and the development of associated diseases.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Affiliations

  1. Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Ehime, 791-0295, Japan

    Teruki Miyake, Teru Kumagi, Masashi Hirooka, Mitsuhito Koizumi, Shinya Furukawa, Teruhisa Ueda, Yoshio Tokumoto, Yoshio Ikeda, Masanori Abe, Yoichi Hiasa, Bunzo Matsuura & Morikazu Onji

  2. Ehime General Health Care Association, Ehime, Japan

    Mitsuhito Koizumi & Kohichiro Kitai

Authors
  1. Teruki Miyake
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  2. Teru Kumagi
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  3. Masashi Hirooka
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  4. Mitsuhito Koizumi
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  5. Shinya Furukawa
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  6. Teruhisa Ueda
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  7. Yoshio Tokumoto
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  8. Yoshio Ikeda
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  9. Masanori Abe
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  10. Kohichiro Kitai
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  11. Yoichi Hiasa
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  12. Bunzo Matsuura
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  13. Morikazu Onji
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Corresponding author

Correspondence to Morikazu Onji.

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Miyake, T., Kumagi, T., Hirooka, M. et al. Metabolic markers and ALT cutoff level for diagnosing nonalcoholic fatty liver disease: a community-based cross-sectional study. J Gastroenterol 47, 696–703 (2012). https://doi.org/10.1007/s00535-012-0534-y

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  • DOI: https://doi.org/10.1007/s00535-012-0534-y

Keywords

  • Alanine aminotransferase
  • Metabolic markers
  • Nonalcoholic fatty liver disease
  • NAFLD index