Abnormal Liver Enzymes in Thai Patients with Metabolic Syndromes
Mayuree Homsanit MD, MPH, PhD*, Anawin Sanguankeo**, Sikarin Upala**, Kamol Udol MD, MSc*
Affiliation : * Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok Thailand ** Medical student, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok Thailand
Objective : Elevated transaminases have been found to be associated with metabolic syndrome (MS) in many populations but
little is known in Asians. The present study aimed to investigate the association between elevated hepatic enzymes in Thai
patients diagnosed with MS.
Material and Method: A cross-sectional study on 2,585 Thais was conducted. Blood pressure, waist circumference, fasting
plasma glucose, triglyceride, HDL-cholesterol, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and
alkaline phosphatase (ALP) were measured. MS was diagnosed using NCEP/ATP III criteria with modified waist circumference
for Asian. The association between MS with elevated liver enzymes was performed using logistic regression.
Results : Twenty-seven percent of the subjects were found to have MS. The MS group had significantly higher mean AST, ALT,
and ALP levels than the non-MS group (mean (SD) for AST 29.86 (18.97), 24.08 (12.71); ALT 38.39 (29.14), 24.38 (18.57);
and ALP 73.45 (27.09), 65.72 (21.27) for MS and non-MS, respectively, p < 0.05). MS was significantly associated
with elevated liver enzymes. The adjusted odds ratios (OR) were 2.2 (95% confidence interval (CI): 1.6-2.9), 2.3 (95% CI:
1.8-3.0), and 2.2 (95% CI: 1.1-4.2) for elevated AST, ALT, and ALP, respectively. ALT/AST ratio of > 1 was significantly
associated with MS in both genders (adjusted ORs: 1.72 (95% CI: 1.28-2.32) for men and 2.30 (95% CI: 1.68-3.16) for
women).
Conclusion : There is a strong association between metabolic syndrome and elevated liver enzymes. Further study is needed
to investigate the long-term sequelae of liver abnormalities in those with metabolic syndrome in Thai population.
Keywords : Metabolic syndrome, Elevated liver enzymes
