STUDY OF SERUM ALANINE-AMINOTRANSFERASE LEVELS IN BLOOD-DONORS IN SPAIN

Background and Objective. Serum alanine-aminotransferase (ALT) is bein g used as a surrogate test for preventing post-transfusion viral hepat itis. However, ALT elevation is influenced by many factors. We have st udied ALT levels in 1,036 consecutive blood donors to determine their association with gender, obesity, and hepatitis virus infection marker s. Design and Methods. In each donation aspartate-aminotransferase (AS T), lactate dehydrogenase (LDH) and gamma-glutamyl transferase (gamma GT) activity were also determined and body mass index (BMI) was calcul ated. Results. Five hundred seventy-nine men and 457 women donated blo od; ALT activity was 25.3+/-14.5 IU/L (mean+/-SD) for men and 16.3+/-7 .9 IU/L for women (p less than or equal to 0.0005). The upper normal v alue for men was 56 IU/L and 34 IU/L for women. On applying this value to the study group 4.8% of the men and 2% of the women had values gre ater than the cutoff. Among the men with increased ALT levels, 53.5% h ad a BMI >27, 7.1% also had an increased level of GGT and 7.1% had inc reased levels of AST and LDH. None of them were HBsAg nor anti-HCV pos itive. Among the women with increased ALT, 33.3% had BMI >27, 33.3% ha d increased levels of LDH and AST, and 11.1% were anti-NOV positive (o nly 1 donor). Interpretation and Conclusions. It seems clear that diff erent cutoff values should be considered for men and women. Factors su ch as obesity, may account for more than 50% of the cases with increas ed ALT values, indicating the low specificity of the test. (C) 1998, F errata Storti Foundation.