What cause alanine aminotransferase levels to elevate persistently among Iranian general population?

NAFLD was the most common cause of persistently elevated serum ALT levels .The importance of NAFLD and ALT elevation is their impact on mortality as a component of the metabolic syndrome. NAFLD is not a western disease, and is the most frequent cause of persistently elevated serum ALT level in the Asia-Pacific region

This study, performed by a team led by Dr. A. Pourshams, is described in a research article to be published on May 14, 2008 in the World Journal of Gastroenterology.

In view of the authors, NAFLD has been recognized as the main cause of chronic liver injury not only in western countries but also in developing countries. NAFLD is the hepatic manifestation of the metabolic syndrome that includes insulin resistance, obesity, hyperlipidemia and hypertension. NAFLD is recognized by fat infiltration in hepatocytes and inflammatory reaction in the liver. Prevalence of NAFLD in Iranian populations is comparable to the western countries. Obesity and other manifestations of the metabolic syndrome in addition to urban life style are the main risk factors for NAFLD. National planning to increase knowledge regarding NAFLD and control of its risk factors are recommended.

This study showed that living in urban area is associated with 2.04 fold increase in NAFLD, this may be due to daily physical activity, life style and more prevalent of overweight and obesity in urban participants. NAFLD is associated with type 2 diabetes mellitus and glucose intolerance with or without superimposed obesity. The type 2 diabetes has been described in 20% to 75% of NAFLD and may increase the risk of NAFLD more than 2 folds compared with non diabetics.