Yuhan Shao, Hailong Zhu, Xin Chen, Enqiang Feng, Chen Chen, Zhugang Shao, Xiaojing Li, Li Liu
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Receiver operating characteristic (ROC) analysis was performed to estimate the predictive value of ALT, AST and ALT/AST ratio for the diagnosis of MUHO.</p><p><strong>Results: </strong>The risks for MUHO increased across quartiles of ALT level and ALT/AST ratio in both genders. The adjusted odds ratios (ORs) for MUHO in the highest quartile of ALT were 3.20-fold higher than the reference quartile in men and 3.05-fold higher in women. Compared with the first quartile of ALT/AST ratio, the adjusted ORs for MUHO in the highest quartile were 3.64 (95% CI: 3.17-4.19) in men and 3.60 (95% CI: 3.11-4.16) in women, respectively. In ROC curve analysis for predicting MUHO, the area under the ROC curve (AUC) values were 0.63 (<i>p</i> < 0.001) for ALT and 0.64 (<i>p</i> < 0.001) for ALT/AST ratio in men, and 0.62 (<i>p</i> < 0.001) for ALT and 0.64 (<i>p</i> < 0.001) for ALT/AST ratio in women. However, AST was not significantly associated with MUHO both in men and in women (<i>p</i>>0.05).</p><p><strong>Conclusion: </strong>ALT and ALT/AST ratio might be considered as two simple and reliable diagnostic indicators for MUHO in the elderly.</p>","PeriodicalId":12473,"journal":{"name":"Frontiers in Nutrition","volume":"12 ","pages":"1513029"},"PeriodicalIF":4.0000,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973076/pdf/","citationCount":"0","resultStr":"{\"title\":\"Associations of ALT, AST and ALT/AST ratio with metabolically unhealthy obesity in the elderly.\",\"authors\":\"Yuhan Shao, Hailong Zhu, Xin Chen, Enqiang Feng, Chen Chen, Zhugang Shao, Xiaojing Li, Li Liu\",\"doi\":\"10.3389/fnut.2025.1513029\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims: </strong>This study aimed to clarify the effects of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and ALT/AST ratio on metabolically unhealthy obese (MUHO) and to estimate the predictors of MUHO in the elderly.</p><p><strong>Methods: </strong>19,812 individuals aged 65 years and older from a health check-up in Qingdao, China in 2021 were chosen as subjects in the current study. Binary logistic regression models were performed to evaluate the relationship between ALT, AST, ALT/AST ratio and MUHO. Receiver operating characteristic (ROC) analysis was performed to estimate the predictive value of ALT, AST and ALT/AST ratio for the diagnosis of MUHO.</p><p><strong>Results: </strong>The risks for MUHO increased across quartiles of ALT level and ALT/AST ratio in both genders. The adjusted odds ratios (ORs) for MUHO in the highest quartile of ALT were 3.20-fold higher than the reference quartile in men and 3.05-fold higher in women. Compared with the first quartile of ALT/AST ratio, the adjusted ORs for MUHO in the highest quartile were 3.64 (95% CI: 3.17-4.19) in men and 3.60 (95% CI: 3.11-4.16) in women, respectively. In ROC curve analysis for predicting MUHO, the area under the ROC curve (AUC) values were 0.63 (<i>p</i> < 0.001) for ALT and 0.64 (<i>p</i> < 0.001) for ALT/AST ratio in men, and 0.62 (<i>p</i> < 0.001) for ALT and 0.64 (<i>p</i> < 0.001) for ALT/AST ratio in women. 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引用次数: 0
摘要
目的：本研究旨在阐明谷丙转氨酶（ALT）、天冬氨酸转氨酶（AST）和谷丙转氨酶/谷丙转氨酶比值在老年人代谢性不健康肥胖（MUHO）中的作用，并评估MUHO的预测因素。方法：选取2021年在中国青岛体检的年龄在65岁 及以上的19812人作为本研究的对象。采用二元logistic回归模型评价ALT、AST、ALT/AST比值与MUHO之间的关系。采用受试者工作特征（ROC）分析，评估ALT、AST及ALT/AST比值对MUHO诊断的预测价值。结果：在ALT水平和ALT/AST比值的四分位数中，男女MUHO的风险均有所增加。在ALT最高四分位数中，MUHO的调整优势比（ORs）在男性中比参考四分位数高3.20倍，在女性中比参考四分位数高3.05倍。与ALT/AST比值的第一个四分位数相比，MUHO在最高四分位数的调整ORs分别为男性3.64 （95% CI: 3.17-4.19）和女性3.60 （95% CI: 3.11-4.16）。在预测MUHO的ROC曲线分析中，ROC曲线下面积（AUC）值为0.63 （p p p p p>0.05）。结论：ALT和ALT/AST比值可作为老年MUHO简单可靠的诊断指标。
Associations of ALT, AST and ALT/AST ratio with metabolically unhealthy obesity in the elderly.
Aims: This study aimed to clarify the effects of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and ALT/AST ratio on metabolically unhealthy obese (MUHO) and to estimate the predictors of MUHO in the elderly.
Methods: 19,812 individuals aged 65 years and older from a health check-up in Qingdao, China in 2021 were chosen as subjects in the current study. Binary logistic regression models were performed to evaluate the relationship between ALT, AST, ALT/AST ratio and MUHO. Receiver operating characteristic (ROC) analysis was performed to estimate the predictive value of ALT, AST and ALT/AST ratio for the diagnosis of MUHO.
Results: The risks for MUHO increased across quartiles of ALT level and ALT/AST ratio in both genders. The adjusted odds ratios (ORs) for MUHO in the highest quartile of ALT were 3.20-fold higher than the reference quartile in men and 3.05-fold higher in women. Compared with the first quartile of ALT/AST ratio, the adjusted ORs for MUHO in the highest quartile were 3.64 (95% CI: 3.17-4.19) in men and 3.60 (95% CI: 3.11-4.16) in women, respectively. In ROC curve analysis for predicting MUHO, the area under the ROC curve (AUC) values were 0.63 (p < 0.001) for ALT and 0.64 (p < 0.001) for ALT/AST ratio in men, and 0.62 (p < 0.001) for ALT and 0.64 (p < 0.001) for ALT/AST ratio in women. However, AST was not significantly associated with MUHO both in men and in women (p>0.05).
Conclusion: ALT and ALT/AST ratio might be considered as two simple and reliable diagnostic indicators for MUHO in the elderly.
期刊介绍：
No subject pertains more to human life than nutrition. The aim of Frontiers in Nutrition is to integrate major scientific disciplines in this vast field in order to address the most relevant and pertinent questions and developments. Our ambition is to create an integrated podium based on original research, clinical trials, and contemporary reviews to build a reputable knowledge forum in the domains of human health, dietary behaviors, agronomy & 21st century food science. Through the recognized open-access Frontiers platform we welcome manuscripts to our dedicated sections relating to different areas in the field of nutrition with a focus on human health.
Specialty sections in Frontiers in Nutrition include, for example, Clinical Nutrition, Nutrition & Sustainable Diets, Nutrition and Food Science Technology, Nutrition Methodology, Sport & Exercise Nutrition, Food Chemistry, and Nutritional Immunology. Based on the publication of rigorous scientific research, we thrive to achieve a visible impact on the global nutrition agenda addressing the grand challenges of our time, including obesity, malnutrition, hunger, food waste, sustainability and consumer health.
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