Original Article
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 7, 2014; 20(33): 11743-11752
Published online Sep 7, 2014. doi: 10.3748/wjg.v20.i33.11743
Impacts of common factors of life style on serum liver enzymes
Joanna Danielsson, Päivikki Kangastupa, Tiina Laatikainen, Mauri Aalto, Onni Niemelä
Joanna Danielsson, Päivikki Kangastupa, Onni Niemelä, Department of Laboratory Medicine, Seinäjoki Central Hospital and University of Tampere, 60220 Seinäjoki, Finland
Joanna Danielsson, Päivikki Kangastupa, Onni Niemelä, Medical Research Unit, Seinäjoki Central Hospital and University of Tampere, 60220 Seinäjoki, Finland
Tiina Laatikainen, Mauri Aalto, National Institute for Health and Welfare (THL), 00271 Helsinki, Finland
Tiina Laatikainen, The Institute of Public Health and Clinical Nutrition, University of Eastern Finland, 70211 Kuopio, Finland
Tiina Laatikainen, Hospital District of North Karelia, 80210 Joensuu, Finland
Author contributions: Danielsson J analysed the data, drafted the manuscript; Kangastupa P analysed the data; Laatikainen T and Aalto M designed the study, performed data acquisition, revised the manuscript; Niemelä O designed the study and wrote the manuscript.
Supported by Competitive State Research Financing of the Expert Responsibility area of Seinäjoki Central Hospital and University of Tampere, VTR110
Correspondence to: Onni Niemelä, MD, Professor, Department of Laboratory Medicine, Seinäjoki Central Hospital and University of Tampere, Hanneksenrinne 7, 60220 Seinäjoki, Finland. onni.niemela@epshp.fi
Telephone: +358-6-4154719 Fax: +358-6-4154924
Received: December 19, 2013
Revised: January 20, 2014
Accepted: May 19, 2014
Published online: September 7, 2014
Processing time: 261 Days and 18.1 Hours
Abstract

AIM: To investigate the impacts of gender, age and factors of life style (alcohol, overweight, coffee and smoking) on serum liver enzymes.

METHODS: Serum alanine aminotransferase (ALT) and gamma-glutamyltransferase (GGT) were measured from 6269 apparently healthy individuals (2851 men, 3418 women, mean age 45 ± 12 years, range 25-74 years) in a national cross-sectional health survey. All subjects underwent detailed clinical examinations and interviews including the amount and pattern of alcohol use, coffee consumption and smoking habits.

RESULTS: In this population with a mean ± SD alcohol consumption of 65 ± 105 g/wk and body mass index (BMI) of 26.1 ± 4.3 kg/m2, both ALT and GGT were significantly influenced by alcohol use (P < 0.001) and BMI (P < 0.001), whereas smoking increased only GGT (P < 0.001). A significant effect of age on ALT was seen in men (P < 0.001) whereas not in women. Significant two-factor interactions of alcohol use in men were observed with age (ALT: P < 0.01; GGT: P < 0.001) and BMI (GGT: P < 0.05). For ALT, a significant interaction also occurred between BMI and age (P < 0.005). In contrast, women showed significant interactions of alcohol use with BMI (GGT: P < 0.05), smoking (GGT: P < 0.001), and coffee consumption (GGT: P < 0.001).

CONCLUSION: Life-style associated changes in liver enzymes may reflect health risks, which should be considered in the definition of normal limits for liver enzymes.

Keywords: Alcohol; Obesity; Aging; Smoking; Liver enzymes; Oxidative stress

Core tip: The present study among 6269 apparently healthy individuals shows that the early changes in serum alanine aminotransferase and gamma-glutamyltransferase levels show distinct age- and gender-dependent variation according to the amount of alcohol drinking and the presence or absence of overweight. Coffee consumption and smoking also modulate the enzyme levels with different sensitivities between genders. The data should be implicated in the assessment of health risks associated with such factors of life style and when revisiting the concept of normal limits in the clinical use of liver enzymes.