Longitudinal association of obesity, metabolic syndrome and diabetes with risk of elevated aminotransferase levels in a cohort of Mexican health workers
Corresponding Author
Yvonne N. Flores
Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social, Cuernavaca, Morelos, México
Department of Health Policy and Management, Center for Cancer Prevention and Control Research, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, California, USA
Correspondence to: Yvonne N. FLORES, Department of Health Policy and Management, Center for Cancer Prevention and Control Research, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, UCLA, 650 Charles Young Drive South, A2-125 CHS, Box 956900, Los Angeles, California 90095, USA. Email [email protected]Search for more papers by this authorAllyn Auslander
Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, California, USA
Search for more papers by this authorCatherine M. Crespi
Department of Biostatistics, Center for Cancer Prevention and Control Research, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, California, USA
Search for more papers by this authorMichael Rodriguez
Department of Family Medicine, David Geffen School of Medicine, UCLA, Los Angeles, California, USA
Search for more papers by this authorZuo-Feng Zhang
Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, California, USA
Search for more papers by this authorFrancisco Durazo
Department of Digestive Diseases, David Geffen School of Medicine and Pfleger Liver Institute, UCLA, Los Angeles, California, USA
Search for more papers by this authorJorge Salmerón
Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social, Cuernavaca, Morelos, México
Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
Search for more papers by this authorCorresponding Author
Yvonne N. Flores
Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social, Cuernavaca, Morelos, México
Department of Health Policy and Management, Center for Cancer Prevention and Control Research, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, California, USA
Correspondence to: Yvonne N. FLORES, Department of Health Policy and Management, Center for Cancer Prevention and Control Research, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, UCLA, 650 Charles Young Drive South, A2-125 CHS, Box 956900, Los Angeles, California 90095, USA. Email [email protected]Search for more papers by this authorAllyn Auslander
Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, California, USA
Search for more papers by this authorCatherine M. Crespi
Department of Biostatistics, Center for Cancer Prevention and Control Research, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, California, USA
Search for more papers by this authorMichael Rodriguez
Department of Family Medicine, David Geffen School of Medicine, UCLA, Los Angeles, California, USA
Search for more papers by this authorZuo-Feng Zhang
Department of Epidemiology, Fielding School of Public Health, UCLA, Los Angeles, California, USA
Search for more papers by this authorFrancisco Durazo
Department of Digestive Diseases, David Geffen School of Medicine and Pfleger Liver Institute, UCLA, Los Angeles, California, USA
Search for more papers by this authorJorge Salmerón
Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social, Cuernavaca, Morelos, México
Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
Search for more papers by this authorAbstract
Objective
In Mexico, chronic liver disease have been increasingly found along with the rapidly growing prevalence of obesity, diabetes and metabolic syndrome (MS). We aimed to investigate the longitudinal association between these three factors and risk of elevated alanine aminotransferase (ALT) levels (>40 U/L), a marker for liver damage, in a cohort of Mexican adults.
Methods
Data were obtained from two separate waves of the Mexican Health Worker Cohort Study: Wave 1 (2004–2006) and Wave 2 (2011–2013). Unconditional logistic regression models were employed to determine the cross-sectional and longitudinal association between these risk factors and elevated ALT levels.
Results
The prevalence of elevated ALT was significantly higher among men, individuals aged under 60 years, those who were overweight or obese, diabetic, with MS or heavy/binge drinkers. The longitudinal results indicated that weight gain between waves that resulted in a change in body mass index, along with remaining overweight or obese, were significantly associated with an increased risk of elevated ALT levels. A significantly increased risk of developing elevated ALT was also observed among those who acquired diabetes or MS from Wave 1 to Wave 2.
Conclusions
Weight gain and acquiring diabetes or MS are associated with a significant risk of having elevated ALT. These results, within the context of the rapid increase in global obesity rates, call urgently for programs to help to prevent chronic liver disease.
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