The prevalence and etiology of elevated aminotransferase levels in northeastern Taiwan: A community-based study

The northeastern coastal regions of Taiwanare a hyperendemic area for hepatitis B (HBV) and hepatitis C (HCV) infection. We investigated the prevalence of elevated aminotransferase levels and assessed the potential influence of various risk factors among those with elevated levels. We conducted a community-based study from October 2012 to July 2014. Blood tests included liver biochemistry, glucose, lipids, HBsAg, and anti-HCV. The degree of fatty liver disease was evaluated by hepatic ultrasound. A total of 2981 participants were analyzed. The overall prevalence of elevated AST and ALT levels was 10.1% and 14.7%, respectively. On multiple logistic regression analysis, male gender and excess alcohol consumption were independently associated with an elevated AST level. Only male gender, BMI >= 27 kg/m(2), excess alcohol consumption, and moderate or severe fatty liver were significantly associated with an elevated ALT. The adjusted odds ratio (95% confidence interval) for an elevated AST level was 2.27 (1.44-3.66, P = .001) for excess alcohol consumption alone, 2.45 (1.81-3.30, P < .001) for either HBsAg or anti-HCV seropositivity, and 4.04 (1.90-8.60, P < .001) for both excess drinking and a viral infection.Our results indicate that a fatty liver, especially moderate or severe, is the commonest risk factor in individuals with an elevated ALT level, with or without another identifiable cause of chronic liver disease. Viral hepatitis and excess alcohol consumption have synergic effect on an elevated AST level, someone who has viral hepatitis should avoid excess alcohol consumption.