Incremental Predictive Value of Serum AST-to-ALT Ratio for Incident Metabolic Syndrome: The ARIRANG StudyReportar como inadecuado

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The ratio of aspartate aminotransferase AST to alanine aminotransferase ALT is of great interest as a possible novel marker of metabolic syndrome. However, longitudinal studies emphasizing the incremental predictive value of the AST-to-ALT ratio in diagnosing individuals at higher risk of developing metabolic syndrome are very scarce. Therefore, our study aimed to evaluate the AST-to-ALT ratio as an incremental predictor of new onset metabolic syndrome in a population-based cohort study.

Material and Methods

The population-based cohort study included 2276 adults 903 men and 1373 women aged 40–70 years, who participated from 2005–2008 baseline without metabolic syndrome and were followed up from 2008–2011. Metabolic syndrome was defined according to the harmonized definition of metabolic syndrome. Serum concentrations of AST and ALT were determined by enzymatic methods.


During an average follow-up period of 2.6-years, 395 individuals 17.4% developed metabolic syndrome. In a multivariable adjusted model, the odds ratio 95% confidence interval for new onset of metabolic syndrome, comparing the fourth quartile to the first quartile of the AST-to-ALT ratio, was 0.598 0.422–0.853. The AST-to-ALT ratio also improved the area under the receiver operating characteristic curve AUC for predicting new cases of metabolic syndrome 0.715 vs. 0.732, P = 0.004. The net reclassification improvement of prediction models including the AST-to-ALT ratio was 0.23 95% CI: 0.124–0.337, P<0.001, and the integrated discrimination improvement was 0.0094 95% CI: 0.0046–0.0143, P<0.001.


The AST-to-ALT ratio independently predicted the future development of metabolic syndrome and had incremental predictive value for incident metabolic syndrome.

Autor: Dhananjay Yadav , Eunhee Choi , Song Vogue Ahn, Soon Koo Baik, Youn zoo Cho, Sang Baek Koh, Ji Hye Huh, Yoosoo Chang, Ki-Chul Sun



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