The present study included 1,333 participants, of whom 311 were defined as having sarcopenia. The clinical characteristics of the population according to sarcopenia are shown in Table 1. Participants in the sarcopenia group were older than those in the non-sarcopenia group (68.0 ± 11.0 vs. 66.0 ± 8.0, respectively; p < 0.001). Compared with the non-sarcopenia group, the sarcopenia group had a significantly lower BMI (24.03 ± 3.10 and 23.53 ± 3.25, respectively; p < 0.05), serum albumin levels (46.12 ± 3.19 and 45.46 ± 4.07, respectively; p < 0.05), hemoglobin levels (143.42 ± 13.7 and 140.9 ± 15.4, respectively; p < 0.05), CC (34.2 ± 3.3 and 33.2 ± 3.4, respectively; p < 0.001), and ALT levels (21.37 ± 8.33 and 19.51 ± 8.71, respectively; p = 0.001). There was no difference between the two groups in the proportion of ever-smokers. However, the proportion of ever-drinkers was significantly higher in the sarcopenia group.
Table 1
Characteristics of the study population according to sarcopenia
Characteristics | Non-sarcopenia (n = 1,022) | Sarcopenia (n = 311) | p-value a |
Age, years, median (IQR) | 66.0 (8.0) | 68.0 (11.0) | < 0.001 |
Women, n (%) | 510 (49.9) | 163 (52.4) | 0.438 |
Ever-smoker, n (%) | 187 (18.3) | 70 (22.5) | 0.099 |
Ever-drinker, n (%) | 279 (27.3) | 104 (33.4) | 0.036 |
Education, n (%) | | | |
< 7 years | 359 (35.1) | 126 (40.5) | 0.009 |
7–12 years | 546 (53.4) | 167 (53.7) | |
> 12 years | 117 (11.4) | 18 (5.8) | |
Hypertension, n (%) | 255 (25.1) | 80 (26.2) | 0.704 |
Diabetes, n (%) | 107 (10.6) | 43 (14.1) | 0.092 |
COPD, n (%) | 79 (7.8) | 22 (7.2) | 0.729 |
CHD, n (%) | 48 (4.7) | 17 (5.6) | 0.563 |
BMI, kg/m2 | 24.03 (3.10) | 23.53 (3.25) | 0.015 |
Serum albumin, g/L | 46.12 (3.19) | 45.46 (4.07) | 0.003 |
ALT, IU/L | 21.37 (8.33) | 19.51 (8.71) | 0.001 |
GGT, IU/L | 19.0 (14.0) | 20.0 (13.0) | 0.764 |
Fasting glucose, mmol/L | 5.90 (1.59) | 6.02 (1.75) | 0.229 |
Hemoglobin, g/L | 143.42 (13.7) | 140.9 (15.4) | 0.007 |
CC, cm | 34.2 (3.3) | 33.2 (3.4) | < 0.001 |
Data are presented as mean and standard deviation if not specified. |
Abbreviations: ALT, alanine aminotransferase; BMI, body mass index; CC, calf circumference; CHD, coronary heart disease; COPD, chronic obstructive pulmonary disease; GGT, gamma-glutamyl transferase; IQR, interquartile range. |
a. Group differences were analyzed using the two independent-sample t-test, Mann-Whitney U test, and Chi-square test as appropriate. |
Table 2 shows sex-specific differences in baseline characteristics according to ALT quartiles (Q1-Q4). In men, the age and proportion of ever-smokers decreased with increasing ALT quartiles. BMI, serum albumin, GGT, fasting glucose, hemoglobin levels, and CC showed an increasing trend with increasing ALT quartiles. The proportions of patients with chronic conditions did not differ among ALT quartiles. In women, BMI, GGT levels, and fasting glucose levels showed an increasing trend with increasing ALT quartiles. From the lowest to the highest ALT quartile, the proportion of patients with hypertension increased.
Table 2
Characteristics of the study population according to alanine aminotransferase quartiles
Men (n = 660) | |
Characteristics | ALT quartiles (IU/L) | p-value |
Q1 (< 16) (n = 160) | Q2 (16–21) (n = 153) | Q3 (21–27) (n = 168) | Q4 (≥ 27) (n-179) |
Age, years, median (IQR) | 69.0 (11.0) | 66.0 (11.0) | 66.0 (9.0) | 66.0 (8.0) | 0.002 |
Ever-smoker, n (%) | 74 (46.3) | 63 (41.2) | 51 (30.4) | 54 (30.2) | 0.003 |
Ever-drinker, n (%) | 74 (46.3) | 72 (47.1) | 79 (47.0) | 81 (45.3) | 0.985 |
Hypertension, n (%) b | 44 (27.7) | 30 (19.9) | 44 (26.3) | 44 (24.9) | 0.409 |
Diabetes, n (%) b | 10 (6.3) | 20 (13.2) | 23 (13.9) | 18 (10.2) | 0.115 |
COPD, n (%) b | 10 (6.3) | 10 (6.6) | 13 (7.8) | 14 (7.9) | 0.921 |
CHD, n (%) b | 7 (4.4) | 8 (5.3) | 6 (3.6) | 6 (3.4) | 0.821 |
BMI, kg/m2 | 23.06 (2.88) | 23.85 (2.85) | 24.06 (2.89) | 23.9 (2.93) | < 0.001 |
Serum albumin, g/L | 45.35 (3.17) | 46.30 (3.17) | 46.42 (2.67) | 46.05 (3.19) | 0.012 |
GGT, IU/L | 18.0 (10.0) | 19.0 (15.0) | 24.5 (18.8) | 24.0 (20.0) | < 0.001 |
Fasting glucose, mmol/L | 5.59 (1.43) | 5.80 (1.35) | 6.08 (1.54) | 6.20 (2.18) | 0.005 |
Hemoglobin, g/L | 146.18 (13.70) | 151.10 (13.30) | 152.73 (13.02) | 152.47 (12.56) | < 0.001 |
CC, cm | 35.1 (2.9) | 35.4 (2.5) | 35.9 (2.8) | 36.3 (3.0) | 0.001 |
Women (n = 673) | |
Characteristics | ALT quartiles (IU/L) | p-value |
Q1 (< 14) (n-156) | Q2 (14–18) (n = 157) | Q3 (18–24) (n = 190) | Q4 (≥ 24) (n = 170) |
Age, years, median (IQR) | 66.5 (9.0) | 66.0 (9.0) | 67.0 (9.0) | 65.0 (7.3) | 0.249 |
Ever-smoker, n (%) | 17 (10.9) | 15 (9.6) | 23 (12.1) | 22 (12.9) | 0.787 |
Ever-drinker, n (%) | 6 (3.8) | 1 (0.6) | 3 (1.6) | 5 (2.9) | 0.216 |
Hypertension, n (%) c | 24 (15.6) | 39 (25.0) | 58 (31.2) | 52 (30.8) | 0.004 |
Diabetes, n (%) c | 16 (10.4) | 21 (13.4) | 19 (10.2) | 23 (13.6) | 0.650 |
COPD, n (%) c | 18 (11.7) | 13 (8.3) | 11 (5.9) | 12 (7.1) | 0.252 |
CHD, n (%) c | 8 (5.2) | 11 (7.0) | 13 (7.0) | 6 (3.6) | 0.453 |
BMI, kg/m2 | 22.91 (3.23) | 23.65 (3.08) | 24.01 (3.39) | 24.84 (3.36) | < 0.001 |
Serum albumin, g/L | 45.87 (3.94) | 46.38 (2.86) | 45.52 (4.30) | 45.82 (3.13) | 0.181 |
GGT, IU/L | 15.0 (7.0) | 15.0 (8.0) | 18.0 (10.0) | 25.0 (10.0) | < 0.001 |
Fasting glucose, mmol/L | 5.74 (1.36) | 5.79 (1.10) | 5.93 (1.76) | 6.23 (1.83) | 0.019 |
Hemoglobin, g/L | 133.32 (10.66) | 135.15 (9.62) | 135.87 (10.10) | 136.06 (10.35) | 0.062 |
CC, cm | 31.69 (2.59) | 32.06 (2.65) | 32.14 (3.04) | 32.51 (2.79) | 0.132 |
Data are presented as mean and standard deviation if not specified. |
Abbreviations: ALT, alanine aminotransferase; BMI, body mass index; CC, calf circumference; CHD, coronary heart disease; COPD, chronic obstructive pulmonary disease; GGT, gamma-glutamyl transferase; IQR, interquartile range. |
a. Group differences were analyzed using the one-way ANOVA, Kruskal-Wallis test, and Chi-square test as appropriate. |
b. Missing data: n = 6. |
c. Missing data: n = 8. |
Sarcopenia is defined as low skeletal muscle mass and low handgrip strength and/or low GS. The ALT levels, ASM, and handgrip strength in both sexes are shown in Fig. 1. The association between ALT levels and sarcopenic diagnosis criteria was also explored (Fig. 2). Men with sarcopenia or low handgrip strength had lower ALT levels than those without sarcopenia or low handgrip strength. Similar results were found in women. The sarcopenia group and the low ASMI group had lower ALT levels than the non-sarcopenia group and the normal ASMI group. There was no significant difference in ALT levels among different gait speeds in either sex.
Logistic regression analysis was performed to determine the effect of ALT levels on the prevalence of sarcopenia. Logistic regression models were adjusted for age, sex, BMI, hemoglobin levels, CC, and serum albumin levels. Compared with the highest ALT quartile, the odds ratio (OR) for individuals in the lowest ALT quartile was found to be increased (OR 1.68, 95% confidence interval 1.13–2.49, P = 0.010; Fig. 3). Additionally, age increased the risk of sarcopenia, whereas CC decreased the risk.