Prevalence of transaminase abnormalities in asymptomatic, healthy subjects participating in an executive health-screening program

The objective of this study was to characterize the prevalence of asymptomatic liver transminase ( LT) abnormalities in a healthy, low-risk adult population and identify associated risk factors. We reviewed 2340 completed medical records of participants in our Executive Health Program, which provided screening medical evaluations for executives. LT ( alanine aminotransferase and aspartate aminotransferase) were considered abnormal if they above normal range for our laboratory. Subjects were excluded if they had a history of viral hepatitis, nonviral liver disease, or an identifiable cause of LT elevation. Of the 2340 subjects 2294 met inclusion criteria and all had AST recorded, but only 1309 had ALT recorded. In all, 341 subjects ( 14.9%) were found to have abnormal LT and in those who had less than 3 drinks per day, 13.9% had elevated LT and 3.6% had LT twice the upper limit of normal. Of the 1309 subjects in whom both AST and ALT were measured, 20.8% had abnormal LT and 6.3% had LT twice the upper limit of normal. On univariate analysis age < 60 ( P = 0.005), male sex ( P < 0.0001), body mass index, greater than or equal to30 ( P < 0.0001), cholesterol, ≥ 200 mg/dl (P = 0.018), and triglycerides, ≥200 mg/dl ( P < 0.0001) were associated with abnormal LT; all these variables except cholesterol were significant by logistic regression analysis. The odds ratio of abnormal LT and LT 2 times normal was 1.79 ( CI 1.20-2.68) and 2.50 (CI 1.04-6), respectively, in subjects with one risk factor, and 2.80 ( CI 1.07-7.34) and 4.73 (CI 0.91-24.5), respectively, in subjects with four risk factors. In conclusion, there is a high prevalence of LT abnormalities in this healthy population. Subjects with multiple risk factors should be considered for screening.