Significance of ALT/AST ratio for specifying subjects with metabolic syndrome in its silent stage

AimsAssociation between metabolic syndrome (MetS) and non-alcoholic fatty liver disease (NAFLD) was verified and significance of liver function tests, especially alanine aminotransferase/aspartate aminotransferase ratio (ALT/AST) to evaluate the statuses of MetS and/or visceral fat accumulation was examined.Materials and MethodsAfter excluding subjects with liver diseases other than NAFLD, 1643 male and 1764 female Japanese were cross-sectionally examined. The diagnosis of MetS was done by its clinical criteria for Japanese with some modifications.ResultsLevels of AST, ALT, gamma glutamyl transpeptidase and ALT/AST were significantly higher in subjects with MS than in those without it. Stepwise regression analyses indicated that AST, ALT, and ALT/AST in male and ALT/AST in female were significantly associated with waist circumference (WC), a marker of visceral fat accumulation. Among these associations, the association between WC and ALT/AST was always significant even when subjects with normal level of ALT of WC were selectively examined.ConclusionsNAFLD can be considered as one of morbid conditions of MetS, i.e. visceral fat accumulation. Among liver function test items, ALT/AST could be a powerful index reflecting their progression even in their pre-diagnosis/silent phases.