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Good Confidence
Cohort StudyPubMed Abstract2007

Prevalence of elevated alanine aminotransferase among US adolescents and associated factors: NHANES 1999-2004

Fraser A, Longnecker MP, Lawlor DA • Gastroenterology

Key Finding

Elevated ALT (>30 U/L) associated with waist circumference and insulin resistance even in young population; males OR 7.7, fasting insulin per 1 SD OR 1.6

Key Findings

  • 1ALT >30 U/L prevalence: males 12.4%, females 3.5%
  • 2Sex (male vs female) OR 7.7 (95% CI 3.9-15.1)
  • 3Fasting insulin (per 1 SD) OR 1.6 (95% CI 1.2-2.1)
  • 4ALT elevation associated with waist circumference and insulin resistance in youth

Original title: “Prevalence of elevated alanine aminotransferase among US adolescents and associated factors: NHANES 1999-2004”

Plain English Summary

Cross-sectional analysis of 5,586 adolescents aged 12-19 from NHANES 1999-2004 examining ALT elevation prevalence and associated factors including sex, ethnicity, waist circumference, and insulin resistance.

In-Depth Analysis

Study Details

Authors: Abigail Fraser, Matthew P Longnecker, Debbie A Lawlor
Journal: Gastroenterology, 2007 Dec; 133(6):1814-20
PMID: 18054554 | PMCID: PMC2180388

Key Statistics (from original paper)

Study Population
  • •N = 5,586 adolescents
  • •Ages 12-19 years
  • •NHANES 1999-2004
ALT Prevalence (>30 U/L) by Demographics

By Ethnicity:

  • •White adolescents: 7.4%
  • •Mexican American adolescents: 11.5%
  • •Black adolescents: 6.0%

By Sex:

  • •Male: 12.4%
  • •Female: 3.5%
Multivariable Associations with Elevated ALT
FactorOdds Ratio95% CI
Sex (male vs female)7.73.9-15.1
Ethnicity (Mexican American vs white)1.61.0-2.6
Waist circumference (per 1 SD)1.41.0-2.0
Fasting insulin (per 1 SD)1.61.2-2.1

Authors' Conclusion

ALT elevation "associated with waist circumference and insulin resistance even in a young population."

Source: PubMed abstract (PMID 18054554)

Paradigm Relevance

How this study applies to different clinical perspectives:

Standard Medical

Relevant

Conventional clinical guidelines used by most doctors

Why it matters:

Supports screening for metabolic risk factors in adolescents with elevated ALT. Highlights ethnic disparities in liver health.

Research Consensus

Relevant

Current scientific understanding, often ahead of guidelines

Why it matters:

Demonstrates early metabolic-liver connection. Insulin resistance predicts ALT elevation even in youth, supporting early intervention.

Metabolic Optimization

Relevant

Proactive targets for optimal health, not just disease absence

Why it matters:

Validates ALT as metabolic health marker across ages. Young people with elevated ALT should address insulin sensitivity through lifestyle, not wait for disease.

Study Details

Type
Cohort Study
Methodology
N = 5,586 adolescents aged 12-19 years. Cross-sectional analysis of NHANES 1999-2004 data. Multivariable regression analysis.

Evidence Quality

Grade A - Large nationally representative sample. PMC2180388. Demonstrates metabolic associations with liver enzymes in youth.

Topic

Liver HealthInsulin ResistanceObesity

Related Biomarkers

ALTLIVER ENZYMESINSULIN

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ALT

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Original Source

View on PubMedView DOIFull Text (Open Access)

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