ArticleBMC pulmonary medicine2020
Baseline low ALT activity is associated with increased long-term mortality after COPD exacerbations.
Article in BMC pulmonary medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Chronic Obstructive Pulmonary Disease and the Management of Cardiopulmonary Risk in the UK: A Systematic Literature Review and Modified Delphi Study.International journal of chronic obstructive pulmonary disease · 2025Pooled it
- Low Alanine Aminotransferase Blood Activity, a Biomarker of Sarcopenia and Frailty, is Associated With Worse Post-Total Laryngectomy Clinical Outcomes. A Retrospective Analysis of 427 Patients.Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery · 2026Article
- Abnormal Serum Albumin, Alanine Aminotransferase, and Blood Urea Nitrogen are Associated with Higher Risks for Mechanical Ventilation and In-Hospital Mortality in COVID-19 Positive US Veterans.Biomarker insights · 2026Article
- Identification of Risk Factors for 30-Day and Frequent One-Year Readmissions in Chronic Obstructive Pulmonary Disease Patients Following Acute Exacerbation.International journal of chronic obstructive pulmonary disease · 2026Article
- Mendelian Randomization Study in East Asian Populations Supports the Causal Relationship Between Blood Metabolites and COPD: Insights from Amino Acids, Phospholipids, Vitamin D, and Trace Elements.International journal of chronic obstructive pulmonary disease · 2026Article
- Body Composition in Cases with Normal Alanine Aminotransferase Values in Medical Health Checkups.Nutrients · 2024Article
- Article
- Low Skeletal Muscle Mass and Clinical Outcomes in Chronic Obstructive Pulmonary Disease.Tuberculosis and respiratory diseases · 2023Article
- Article
- Long-Term Clinical Outcomes of Patients with Chronic Obstructive Pulmonary Disease with Sarcopenia.Life (Basel, Switzerland) · 2023Article
- Circulating liver function markers and the risk of COPD in the UK Biobank.Frontiers in endocrinology · 2023Article
- Determination of skeletal muscle mass by aspartate aminotransferase / alanine aminotransferase ratio, insulin and FSH in Chinese women with sarcopenia.BMC geriatrics · 2022Article
- Association between ALT/AST and Muscle Mass in Patients with Type 2 Diabetes Mellitus.Mediators of inflammation · 2022Article
- High Serum AST/ALT Ratio and Low Serum INS*PA Product Are Risk Factors and Can Diagnose Sarcopenia in Middle-Aged and Older Adults.Frontiers in endocrinology · 2022Article
- Association of Low Alanine Aminotransferase Values with Extubation Failure in Adult Critically Ill Patients: A Retrospective Cohort Study.Journal of clinical medicine · 2021Article
- Low alanine aminotransferase as a risk factor for chronic obstructive pulmonary disease in males.Scientific reports · 2021Observational
- Low ALT Levels Associated with Poor Outcomes in 8700 Hospitalized Heart Failure Patients.Journal of clinical medicine · 2020Article
- Frailty and Sarcopenia Assessment upon HospitalAdmission to Internal Medicine Predicts Length ofHospital Stay and Re-Admission: A ProspectiveStudy of 980 Patients.Journal of clinical medicine · 2020Article
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCOPD exacerbations have negative impact on patients' survival. Several risk factors for grave outcomes of such exacerbations have been descried. Muscle dysfunction and mass loss were shown to impact negatively on prognosis and survival. Low activity of the enzyme ALT (Alanine amino-transferase) in the blood is a known indicator for sarcopenia and frailty, however, no previous studies addressed the association of low ALT amongst patients hospitalized due to COPD exacerbation and long-term survival.
methodsThis is a historic prospective cohort study of patients hospitalized due to acute COPD exacerbation.
resultsIncluded were 232 consecutive COPD exacerbation patients. The median time of follow-up was 34.9 months (IQR 23.13-41.73 months). During this period 104 (44.8%) patients died. All patients were grouped to quartiles according to blood ALT levels (after exclusion of cases considered to have hepatic tissue damage (ALT > 40 IU)). The risk of long-term mortality increased, in a statistically significant manner, amongst patients with low ALT values: the median survival of patients with ALT < 11 IU was 18.5 months only while the median survival for the rest of the study group was not reached. For ALT < 11 IU; 12-16 IU; 17-20 IU and > 21 IU the mortality rates were 69%; 40.9%; 36.3 and 25% respectively (p < 0.001 for comparison of lower quartile with upper three quartiles). The crude hazard ratio for mortality amongst patients with ALT levels lower than 11 IU was 2.37 (95% CI; 1.6-3.5). This increased risk of mortality remained significant after adjustment for age, weight, creatinine, albumin concentration and cardiovascular diseases (HR = 1.83; 95% CI 1.08-3.1, p < 0.05).
conclusionsLow ALT values, a biomarker of sarcopenia and frailty, are associated with poor long-term survival amongst patients hospitalized due to COPD exacerbation.
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