Serum Aminotransferases Levels in Obese and Normal Individuals in Tertiary Care Centre: A Case-Control Study

Dr. S. J. Sanketh; Dr. M.G. Herakall; Dr. Mahesh Poojari

doi:10.36437/irmhs.2025.8.1.A

Dr. S. J. Sanketh Department of General Medicine, S. Nijalingappa Medical College & HSK Hospital & Research Centre, Bagalkot, Karnataka, India.
Dr. M.G. Herakall Department of General Medicine, S. Nijalingappa Medical College & HSK Hospital & Research Centre, Bagalkot, Karnataka, India.
Dr. Mahesh Poojari Department of General Medicine, S. Nijalingappa Medical College & HSK Hospital & Research Centre, Bagalkot, Karnataka, India.

DOI: https://doi.org/10.36437/irmhs.2025.8.1.A

Keywords: Aminotransferases, Body Mass Index, Liver Enzymes, Metabolic Diseases, Obesity

Abstract

Background and Objectives: Obesity represents a significant global health challenge with potential metabolic complications. This case-control study aimed to comparatively evaluate serum aminotransferase levels in obese and normal-weight individuals to understand the relationship between obesity and hepatic enzyme alterations.

Methods: A Case-Control study was conducted in a tertiary care centre involving 100 participants (50 obese and 50 normal-weight controls), aged 20-60 years. Participants were classified based on Body Mass Index (BMI). Serum levels of Alanine Aminotransferase (ALT), Aspartate Aminotransferase (AST), and Alkaline Phosphatase (ALP) were measured using standardized biochemical techniques. Demographic data, anthropometric measurements, and enzyme levels were systematically recorded and statistically analyzed.

Results: Significant differences were observed in serum aminotransferase levels between obese and normal-weight groups. Mean ALT levels were 62.4 ± 22.7 U/L in obese participants compared to 35.2 ± 8.9 U/L in controls (p<0.001). Similarly, AST levels were 54.6 ± 18.3 U/L in obese individuals versus 32.7 ± 6.5 U/L in normal-weight participants (p<0.001). The prevalence of elevated enzyme levels was substantially higher in the obese group: 38% for ALT >50 U/L, 32% for AST >40 U/L, and 28% for ALP >75 U/L. Odds ratios demonstrated a significantly increased risk of enzyme elevation in obese participants (ALT OR 7.42, 95% CI 2.31-23.85).

Conclusion: The study reveals a significant association between obesity and elevated serum aminotransferase levels, suggesting potential hepatic metabolic alterations in obese individuals. These findings underscore the importance of comprehensive metabolic monitoring and early interventions in obesity management.

References

World Health Organization. Obesity and overweight fact sheet [Internet]. 2021 [cited 2024 Jan 15]. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight

Chooi YC, Ding C, Magkos F. The epidemiology of obesity. Metabolism. 2019 Mar;92:6-10. doi: https://doi.org/10.1016/j.metabol.2018.09.005

Younossi ZM, Koenig AB, Abdelatif D, Fazel Y, Henry L, Wymer M. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016 Jul;64(1):73-84. doi: https://doi.org/10.1002/hep.28431

Chalasani N, Younossi Z, Lavine JE, Charlton M, Cusi K, Rinella M, Harrison SA, Brunt EM, Sanyal AJ. The diagnosis and management of nonalcoholic fatty liver disease: Practice guidance from the American Association for the Study of Liver Diseases. Hepatology. 2018 Jan;67(1):328-357. doi: https://doi.org/10.1002/hep.29367

Kim WR, Flamm SL, Di Bisceglie AM, Bodenheimer HC; Public Policy Committee of the American Association for the Study of Liver Disease. Serum activity of alanine aminotransferase (ALT) as an indicator of health and disease. Hepatology. 2008 Apr;47(4):1363-70. doi: https://doi.org/10.1002/hep.22109

Chen S, Guo X, Zhang X, Yu S, Yang H, Jiang M, Sun G, Sun Y. Association between elevated serum alanine aminotransferase and cardiometabolic risk factors in rural Chinese population: a cross-sectional study. BMC CardiovascDisord. 2015 Jul 10;15:65. doi: https://doi.org/10.1186/s12872-015-0060-y

Ruhl CE, Everhart JE. Determinants of the association of overweight with elevated serum alanine aminotransferase activity in the United States. Gastroenterology. 2003 Jan;124(1):71-9. doi: https://doi.org/10.1053/gast.2003.50004

Fabbrini E, Sullivan S, Klein S. Obesity and nonalcoholic fatty liver disease: biochemical, metabolic, and clinical implications. Hepatology. 2010 Feb;51(2):679-89. doi: https://doi.org/10.1002/hep.23280

Kunutsor SK, Apekey TA, Walley J. Liver aminotransferases and risk of incident type 2 diabetes: a systematic review and meta-analysis. Am J Epidemiol. 2013 Jul 15;178(2):159-71. doi: https://doi.org/10.1093/aje/kws469

Ballestri S, Zona S, Targher G, Romagnoli D, Baldelli E, Nascimbeni F, Roverato A, Guaraldi G, Lonardo A. Nonalcoholic fatty liver disease is associated with an almost twofold increased risk of incident type 2 diabetes and metabolic syndrome. Evidence from a systematic review and meta-analysis. J GastroenterolHepatol. 2016 May;31(5):936-44. doi: https://doi.org/10.1111/jgh.13264

Duseja A, Singh SP, Saraswat VA, Acharya SK, Chawla YK, Chowdhury S, Dhiman RK, Jayakumar RV, Madan K, Misra SP, Mishra H, Modi SK, Muruganathan A, Saboo B, Sahay R, Upadhyay R. Non-alcoholic Fatty Liver Disease and Metabolic Syndrome-Position Paper of the Indian National Association for the Study of the Liver, Endocrine Society of India, Indian College of Cardiology and Indian Society of Gastroenterology. J ClinExpHepatol. 2015 Mar;5(1):51-68. doi: https://doi.org/10.1016/j.jceh.2015.02.006

Mumtaz T, Tariq K, Kanwal K, Tariq Z. A case-control regression analysis of liver enzymes in obesity-induced metabolic disorders in South Asian females. PLoS One. 2024 Jul 18;19(7):e0303835. doi: https://doi.org/10.1371/journal.pone.0303835

Chang Y, Ryu S, Sung E, Jang Y. Higher concentrations of alanine aminotransferase within the reference interval predict nonalcoholic fatty liver disease. Clin Chem. 2007;53:686–692. doi: https://doi.org/10.1373/clinchem.2006.081257

Leite NC, Salles GF, Araujo AL, Villela-Nogueira CA, Cardoso CR. Prevalence and associated factors of non-alcoholic fatty liver disease in patients with type-2 diabetes mellitus. Liver Int. 2009;29:113–119. doi: https://doi.org/10.1111/j.1478-3231.2008.01718.x

Rodríguez-Hernández H, Simental-Mendía LE, Rodríguez-Ramírez G, Reyes-Romero MA. Obesity and inflammation: epidemiology, risk factors, and markers of inflammation. Int J Endocrinol. 2013;2013:678159. doi: https://doi.org/10.1155/2013/678159

Lee S, Kim KW, Lee J, Park T, Khang S, Jeong H, Song GW, Lee SG. Visceral adiposity as a risk factor for lean non-alcoholic fatty liver disease in potential living liver donors. J Gastroenterol Hepatol. 2021 Nov;36(11):3212-3218. doi: https://doi.org/10.1111/jgh.15597

Kim DW, Ha J, Lee SS, Kwon JH, Kim NY, Sung YS, Yoon JS, Suk HI, Lee Y, Kang BK. Population-based and Personalized Reference Intervals for Liver and Spleen Volumes in Healthy Individuals and Those with Viral Hepatitis. Radiology. 2021 Nov;301(2):339-347. doi: https://doi.org/10.1148/radiol.2021204183