ArticleLipids in health and disease2020
Association between the alanine aminotransferase/aspartate aminotransferase ratio and new-onset non-alcoholic fatty liver disease in a nonobese Chinese population: a population-based longitudinal study.
Article in Lipids in health and disease, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 2 of them syntheses that pooled it.
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Who cites it
55 citing papers in PubMed, 2 syntheses or guidelines pooled it, 113 citations in OpenAlex.
- Comparative effectiveness of GLP-1 receptor agonists and dual agonists in the treatment of patients with metabolic dysfunction associated steatohepatitis: a systematic review and meta-analysis.Frontiers in endocrinology · 2025Pooled it
- Epidemiology of lean/non-obese nonalcoholic fatty liver disease in China: A systematic review and meta-analysis.Saudi medical journal · 2023Pooled it
- Mid-upper arm circumference, steatosis indices, and elastography for screening liver steatosis in children with overweight/obesity: A prospective cross-sectional study.Journal of pediatric gastroenterology and nutrition · 2026Article
- Effect of reduction in skeletal muscle quantity and sex differences on postoperative hepatic steatosis following total pancreatectomy.Surgery today · 2026Article
- Association of AGAHR with metabolic dysfunction-associated steatotic liver disease (MASLD).Hormones (Athens, Greece) · 2026Article
- Nonlinear associations of remnant cholesterol/high-density lipoprotein cholesterol ratio with the risk of metabolic-associated fatty liver disease: a cross-sectional study.BMC gastroenterology · 2026Article
- Nonalcoholic Fatty Liver Disease Status and Its Associated Factors Among Patients With Type 2 Diabetes Mellitus in Adama Hospital Medical College, South Eastern Ethiopia: A Cross-Sectional Study.Health science reports · 2026Article
- Analysis of risk factors and correlation between the degree of hepatic steatosis and fibrosis in patients with metabolic dysfunction-associated steatohepatitis.BMC gastroenterology · 2025Article
- ApoJ and apoL1 as novel determinants of MASH: a cross-sectional study.Lipids in health and disease · 2025Article
- The Triglyceride/HDL Ratio as a Non-Invasive Marker for Early-Stage NAFLD: A Retrospective Cross-Sectional Study of 2588 Patients.Diagnostics (Basel, Switzerland) · 2025Article
- A machine learning-based prediction model for colorectal liver metastasis.Clinical and experimental medicine · 2025Article
- Article
- The incremental value of aspartate aminotransferase/alanine aminotransferase ratio combined with CURB-65 in predicting treatment outcomes in hospitalized adult community-acquired pneumonia patients with type 2 diabetes mellitus.BMC pulmonary medicine · 2025Article
- Therapeutic effects of curcumin supplementation on liver enzymes of nonalcoholic fatty liver disease patients: A systematic review and meta-analysis of randomized clinical trials.Food science & nutrition · 2025Review
- Nonlinear association of a composite metabolic index (ZJU index) with hypertension: a cross-sectional study of NHANES 2003-2018.Frontiers in cardiovascular medicine · 2025Article
- Association between the aspartate aminotransferase-to-alanine aminotransferase ratio and the reversion to normoglycemia in people with impaired fasting glucose: a 5-year retrospective cohort study.Frontiers in endocrinology · 2025Article
- Predictive value of serum uric acid to high-density lipoprotein cholesterol ratio for MAFLD in non-obese type 2 diabetes patients based on nomogram.Frontiers in endocrinology · 2025Article
- Association between the ratio of aspartate aminotransferase to alanine aminotransferase and risk of diabetes and the mediating effect of BMI: a comparative analysis in Chinese and Japanese populations.Frontiers in endocrinology · 2025Article
- A nomogram for predicting metabolic-associated fatty liver disease in non-obese newly diagnosed type 2 diabetes patients.Frontiers in endocrinology · 2025Article
- Nonalcoholic Fatty Liver Disease Risk and Proprotein Convertase Subtilisin Kexin 9 in Familial Hypercholesterolemia Under Statin Treatment.Nutrients · 2024Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe alanine aminotransferase (ALT)/aspartate aminotransferase (AST) ratio has been considered an alternative marker for hepatic steatosis. However, few studies have investigated the association of the ALT/AST ratio with non-alcoholic fatty liver disease (NAFLD) in nonobese people.
methodsA total of 12,127 nonobese participants who were free of NAFLD participated in this study. The participants were divided into quintiles of the ALT/AST ratio. Multiple Cox regression models were used to explore the association of the ALT/AST ratio with new-onset NAFLD.
resultsDuring the five-year follow-up period, 2147 individuals (17.7%) developed new-onset NAFLD. After adjusting for all non-collinear covariates, the multiple Cox regression analysis results showed that a higher ALT/AST ratio was independently associated with new-onset NAFLD in nonobese Chinese (adjusted hazard ratios [aHRs]: 2.10, 95% confidence intervals: 1.88, 2.36). The aHRs for NAFLD across increasing quintiles of the ALT/AST ratio were 1, 1.63 (1.30, 2.04), 2.07 (1.65, 2.60), 2.84 (2.33, 3.48) and 3.49 (2.78, 4.39) (P for trend< 0.001). The positive association was more significant among people with high blood pressure, high blood lipids and hyperglycaemia, as well as in men. Additionally, the regression spline showed that the saturation effect of the ALT/AST ratio on NAFLD risk was at 0.93 in this study population, which was 1.22 in males and 0.89 in females.
conclusionsIn nonobese Chinese individuals without NAFLD at baseline, the increase in the ALT/AST ratio is closely associated with the risk of new-onset NAFLD.
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