Relationship between GFR and Serum Transaminase Levels in National Health and Nutrition Examination Survey (NHANES) III

腎功能與血清轉氨脢之關係

顧進裕(Jinn-Yuh Guh) ； 陳鴻鈞(Hung-Chun Chen) ； 賴永勳(Yung-Hsiung Lai)

《Acta Nephrologica》 14卷4期 (2000/10) Pp. 335-335

並列摘要

We had shown that serum transaminase levels (ST) were increased by hepatitis C (HCV) in HD patients. Moreover, ST levels were decreased in HD patients after adjusting for multiple covariates.
The mechanism of decreased ST levels in HD patients in not known. However, chronic renal insufficiency (CRI) and HD are two of the probable mechanisms. Thus, we studied the relationship between degree of CRI and ST in adults (≥17 years old , N=15,584) in a large dataset in the USA (National health and Nutrition Examination Survey [NHANES]III), which was a cross-sectional study of non-institutionalized persons aged ＞2 years from 1998-1994. It was based on a complex multi-stage, stratified sampling design with 48 strata and 96 primary sampling units(clusters). We used SAS” surveymeans” and “surveyreg” to incorporate these complex designs. Multiple linear regression was used: dependent=AST or ALT; independents=race, gender, age,BMI,DM,GFR (group I＜25 ml/min/1.73m2,N=27;II=25-50,N=886;III=50-75,N=5,528;IV＞75,N=9,113), HBsAg, anti-HCV, ferritin, transferring saturation, alcohol and coffee intake.
Results: AST and ALT (U/L) were 17.7±0.96 and 10.96±1 in group l;20.9±0.34 (p＜0.01 vs. I) and 13.6±0.4(P＜0.05 vs. II) in group 3;21.5±0.23 and 18.4±0.45 (P＜0.01 vs. III) in group 4, respectively, In multiple regression, AST was associated positively with male gender, Mexican-American, HBsAg, anti-HCV, feritin and transferring saturation, and negatively with degree of CRI and coffee intake. ALT was associated positively with male gender, Mexican-American, BMI, DM, HBsAg, anti-HCV, ferritin and transferring saturation, and negatively with degree of CRI, White race, Black race, age and coffee intake.
Conclusion: CRI per se decreased ST levels after adjusting for multiple covariate. Thus, like HD patients, the cutoff levels of ST for detecting viral hepatitis should be lowered in patients with CRI.