The alanine aminotransferase to triglycerides ratio as a marker to identify nonalcoholic fatty liver disease

摘要

OBJECTIVE: The aim of this study was to determine whether the alanine aminotransferase to triglycerides (ALT/TGL) ratio is useful to identify nonalcoholic fatty liver disease (NAFLD) in asymptomatic overweight and obese women. METHODS: Asymptomatic overweight and obese women aged 20-65 years were enrolled in a cross-sectional study for evaluating their ALT/TGL ratio, which was considered as a diagnostic test for identifying NAFLD. Alcohol consumption of at least 20 g/week, smoking, positive markers of viral or autoimmune hepatitis, a previous diagnosis of acute or chronic liver disease, renal failure, glomerulopathies, neoplasia, cardiovascular disease, and intake of contraceptives or hepatotoxic drugs were the exclusion criteria. The sensitivity, specificity, and predictive values were calculated. The optimal ALT/TGL ratio to identify NAFLD was determined using a receiver operating characteristic scatter plot analysis. RESULTS: A total of 412 asymptomatic women, average age of 45.1±10.5 years, were enrolled, 199 (48.3%) without NAFLD and 213 (51.7%) with NAFLD. The best cut-off point of the ALT/TGL ratio to identify NAFLD was 7.0, which showed the highest sensitivity (84.0%) and specificity (91.0%). For this cut-off point, the positive and negative predictive values were 91.8 and 84.3%, respectively. The weighted κ test showed a good agreement between the ALT/TGL ratio and the hepatic ultrasound in the identification of NAFLD (κ=0.758). CONCLUSION: The results of this study indicate that the ALT/TGL ratio has a high sensitivity and specificity to identify NAFLD, suggesting that it could be a useful marker to recognize NAFLD in asymptomatic overweight and obese women.