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• W2017100876 abstract "Editorials2 July 2002Alanine Aminotransferase Levels: What's Normal?Marshall M. Kaplan, MDMarshall M. Kaplan, MDTufts–New England Medical Center; Boston, MA 02111Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-137-1-200207020-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Alanine aminotransferase (ALT), a sensitive indicator of liver cell injury, has been used to identify patients with liver disease for almost 50 years (1). This cytosolic enzyme, which is found in many organs, catalyzes the transfer of the α-amino group from alanine to α-ketoglutaric acid (2). Alanine aminotransferase levels are particularly high in the liver. For detection of liver diseases, ALT is thought to be a more specific indicator than aspartate aminotransferase, an enzyme found in cytosol and mitochondria (3). Serum levels of ALT normally are low—167 to 667 nkat/L (10 to 40 U/L) in most laboratories; however, normal values ...References1. Karmen A, Wroblewski F, LaDue JS. Transaminase activity in human blood. J Clin Invest. 1955;34:126-33. CrossrefMedlineGoogle Scholar2. Awapara J, Seale B. Distribution of transaminases in rat organs. J Biol Chem. 1952;194:497-502. CrossrefMedlineGoogle Scholar3. Rej R. Aspartate aminotransferase activity and isoenzyme proportions in human liver tissues. Clin Chem. 1971;24:24-9. Google Scholar4. Kallei L, Hahn A, Roder VZ. Correlation between histological findings and serum transaminase values in chronic diseases of the liver. Acta Medica Scandinavika. 1964;175:49-56. CrossrefMedlineGoogle Scholar5. Prati D, Taioli E, Zanella A, Della Torre E, Butelli S, Del Vecchio E, et al . Updated definitions of healthy ranges for serum alanine aminotransferase levels. Ann Intern Med. 2002;137:1-9. LinkGoogle Scholar6. Wejstål R, Hansson G, Lindholm A, Norkrans G. Persistent alanine aminotransferase elevation in healthy Swedish blood donors—mainly caused by obesity. Vox Sang. 1988;55:152-6. [PMID: 3238949] CrossrefMedlineGoogle Scholar7. Piton A, Poynard T, Imbert-Bismut F, Khalil L, Delattre J, Pelissier E, et al . Factors associated with serum alanine transaminase activity in healthy subjects: consequences for the definition of normal values, for selection of blood donors, and for patients with chronic hepatitis C. MULTIVIRC Group. Hepatology. 1998;27:1213-9. [PMID: 9581673] CrossrefMedlineGoogle Scholar8. Robinson D, Whitehead TP. Effect of body mass and other factors on serum liver enzyme levels in men attending for well population screening. Ann Clin Biochem. 1989;26 5 393-400. [PMID: 2573311] CrossrefMedlineGoogle Scholar9. Manes JL, Taylor HB, Starkloff GB. Relationship between hepatic morphology and clinical and biochemical findings in morbidly obese patients. J Clin Pathol. 1973;26:776-83. [PMID: 4750460] CrossrefMedlineGoogle Scholar10. Sheth SG, Gordon FD, Chopra S. Nonalcoholic steatohepatitis. Ann Intern Med. 1997;126:137-45. [PMID: 9005748] LinkGoogle Scholar11. Bellentani S, Saccoccio G, Masutti F, Crocè LS, Brandi G, Sasso F, et al . Prevalence of and risk factors for hepatic steatosis in Northern Italy. Ann Intern Med. 2000;132:112-7. [PMID: 10644271] LinkGoogle Scholar12. Ludwig J, Viggiano TR, McGill DB, Oh BJ. Nonalcoholic steatohepatitis: Mayo Clinic experiences with a hitherto unnamed disease. Mayo Clin Proc. 1980;55:434-8. [PMID: 7382552] MedlineGoogle Scholar13. Falck-Ytter Y, Younossi ZM, Marchesini G, McCullough AJ. Clinical features and natural history of nonalcoholic steatosis syndromes. Semin Liver Dis. 2001;21:17-26. [PMID: 11296693] CrossrefMedlineGoogle Scholar14. Teli MR, James OF, Burt AD, Bennett MK, Day CP. The natural history of nonalcoholic fatty liver: a follow-up study. Hepatology. 1995;22:1714-9. [PMID: 7489979] CrossrefMedlineGoogle Scholar15. Matteoni CA, Younossi ZM, Gramlich T, Boparai N, Liu YC, McCullough AJ. Nonalcoholic fatty liver disease: a spectrum of clinical and pathological severity. Gastroenterology. 1999;116:1413-9. [PMID: 10348825] CrossrefMedlineGoogle Scholar16. Willett WC, Dietz WH, Colditz GA. Guidelines for healthy weight. N Engl J Med. 1999;341:427-34. [PMID: 10432328] CrossrefMedlineGoogle Scholar17. Calle EE, Thun MJ, Petrelli JM, Rodriguez C, Heath CW. Body-mass index and mortality in a prospective cohort of U.S. adults. N Engl J Med. 1999;341:1097-105. [PMID: 10511607] CrossrefMedlineGoogle Scholar18. Mathurin P, Moussalli J, Cadranel JF, Thibault V, Charlotte F, Dumouchel P, et al . Slow progression rate of fibrosis in hepatitis C virus patients with persistently normal alanine transaminase activity. Hepatology. 1998;27:868-72. [PMID: 9500720] CrossrefMedlineGoogle Scholar19. Martinot-Peignoux M, Boyer N, Cazals-Hatem D, Pham BN, Gervais A, Le Breton V, et al . Prospective study on anti-hepatitis C virus-positive patients with persistently normal serum alanine transaminase with or without detectable serum hepatitis C virus RNA. Hepatology. 2001;34:1000-5. [PMID: 11679971] CrossrefMedlineGoogle Scholar20. Jacobson IM, Russo MW, Lebovics E, Esposito S, Tobias H, Klion F. Interferon alfa-2b and ribavirin for patients with chronic hepatitis C and normal ALT: final results [Abstract]. Gastroenterology. 2002;122:A-627. Google Scholar Author, Article, and Disclosure InformationAffiliations: Tufts–New England Medical Center; Boston, MA 02111Corresponding Author: Marshall M. Kaplan, MD, Tufts–New England Medical Center, 750 Washington Street, Box 233, Boston, MA 02111; e-mail, [email protected]org. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoUpdated Definitions of Healthy Ranges for Serum Alanine Aminotransferase Levels Daniele Prati , Emanuela Taioli , Alberto Zanella , Emanuela Della Torre , Sonia Butelli , Emanuela Del Vecchio , Luciana Vianello , Francesco Zanuso , Fulvio Mozzi , Silvano Milani , Dario Conte , Massimo Colombo , and Girolamo Sirchia Healthy Ranges for Alanine Aminotransferase Levels John R. Senior Drawing Conclusions about Short-Term Variability in Liver Function Test Results Mariana Lazo , Elizabeth Selvin , and Jeanne M. 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Findings from The Korea National Health and Nutrition Examination Survey 2008–2010Approach to Liver Function Tests in ChildrenAmerican Skullcap ( Scutellaria lateriflora ): A Randomised, Double-Blind Placebo-Controlled Crossover Study of its Effects on Mood in Healthy VolunteersUpper Limits of Normal Aminotransferases in Children of Southern IranEpidemiology of Nonalcoholic Fatty Liver Disease (NAFLD)Noninvasive scoring systems in patients with nonalcoholic fatty liver disease with normal alanine aminotransferase levelsRevising the Upper Limit of Normal for Levels of Serum Alanine Aminotransferase in a Middle Eastern Population with Normal Liver HistologyÉlévation modérée, persistante et inexpliquée des transaminasesUpper limit of normal for alanine aminotransferase: Quo vadis?Sensitive detection of hepatocellular injury in chronic hepatitis C patients with circulating hepatocyte-derived microRNA-122Community-Based Epidemiologic Study on Gallstone Disease among Elderly Patients with Type 2 Diabetes in Kinmen, TaiwanStudy on alanine aminotransferase kinetics by microchip electrophoresisOccupational Sharp Injuries and Biological Markers of Hepatitis B and Hepatitis C Viral Infection in NursesLaboratory TestsRapid Development of New Protein Biosensors Utilizing Peptides Obtained via Phage DisplayPesticide risk assessment: A study on inhalation and dermal exposure to 2,4-D and paraquat among Malaysian paddy farmersNonalcoholic Fatty Liver Disease and Type 2 Diabetes Mellitus: The Hidden EpidemicHigh-dose frequency beta-interferons increase the risk of liver test abnormalities in multiple sclerosis: a longitudinal study“Normal” range of alanine aminotransferase levels for Asian populationAssessment of Liver Function in Clinical PracticeVariations in alanine aminotransferase levels within the normal range predict metabolic and androgenic phenotypes in women of reproductive ageHyperandrogenemia Is Independently Associated with Elevated Alanine Aminotransferase Activity in Young Women with Polycystic Ovary SyndromeCarriers of Inactive Hepatitis B Virus Are Still at Risk for Hepatocellular Carcinoma and Liver-Related DeathLiver Chemistry and Function TestsUnintended Hepatic Adverse Events Associated with Cancer ChemotherapyRelationship of hepatic steatosis and alanine aminotransferase with coronary calcificationRelationship between periodontitis and hepatic abnormalities in young adultsDiagnostik bei erhöhten LeberwertenReply:Elevated alanine aminotransferase levels predict mortality from cardiovascular disease and diabetes in KoreansElevations in alanine aminotransferase levels late in the course of antiviral therapy in hepatitis C virus RNA-negative patients are associated with virological relapseAminotransferase Levels and 20-Year Risk of Metabolic Syndrome, Diabetes, and Cardiovascular DiseaseDrawing Conclusions about Short-Term Variability in Liver Function Test ResultsMariana Lazo, MD, ScM, Elizabeth Selvin, PhD, MPH, and Jeanne M. 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Senior, MDHealthy Ranges for Alanine Aminotransferase LevelsDaniele Prati, MD, Agostino Colli, MD, and Dario Conte, MDHealthy ranges of serum alanine aminotransferase levels in Iranian blood donorsLiver biopsy in living donors 2 July 2002Volume 137, Issue 1Page: 49-51KeywordsAlanine aminotransferaseBlood banksBlood donorsBody mass indexFatty liverLiverLiver diseasesNonalcoholic steatohepatitisResearch designSteatosis ePublished: 2 July 2002 Issue Published: 2 July 2002 CopyrightCopyright © 2002 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ..." @default.
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