Accuracy of the alanine aminotransferase test in the identification of glutamic oxaloacetic hypertransaminasemia in healthy adults from Villa el Salvador, Peru

Abstract

Introduction: The measurement of aspartate and alanine aminotransferase are used for the diagnosis and monitoring of different organic disorders. Both tests are part of the "liver profile" routinely requested in private consultations and in health campaigns.

Objective: To determine the diagnostic accuracy of glutamic oxaloacetic hypertransaminasemia by measuring alanine aminotransferase levels in healthy adults who attend preventive health evaluations.

Methodology: Analytical, retrospective, cross-sectional study and non-probabilistic sampling based on the results of 846 patients evaluated from a polyclinic in Villa el Salvador, Peru. The variables were aspartate and alanine aminotransferase. Analysis was performed using the receiver operating characteristic curve, Chi-square, Cramer's V, relative risk, and Spearman's Rho since the distribution was not normal.

Results: The area under the receiver's operating characteristic curve was 0.927 in the total for both sexes, 0.961 in women and 0.910 in men. The values ​​suggested the cut-off point of ALT in women of 42.50 U/L (sensitivity 84%, specificity 85%), in men of 40.50 U/L (sensitivity 95%, specificity 77%) and in the total 39.50 U/L (92% sensitivity, 77% specificity). Chi-square and Cramer's V tests found a strong and positive relationship. Men with elevated ALT had 82.81 times greater risk of elevated AST than men with normal ALT, 32.53 times greater in women and 42.84 times in total.

Conclusions: In healthy adults, simultaneous measurement of alanine and aspartate aminotransferase is not essential. Being able to dispense with aspartate aminotransferase since the measurement of alanine aminotransferase has high sensitivity and specificity to detect both hypertransaminasemias from a diagnostic and economic benefit point of view.