Etiological Analysis And Mechanism Of Asymptomatic Transaminase Elevation In Healthy Population

ObjectiveBy investigating the morbidity and etiology of asymptomatic ALT elevation after physical examination,recruit reexamination and vigorous exercise,and focusing on the two main causes of non-alcoholic fatty liver disease(NAFLD)and hepatic stress injury(HSI),the pathogenesis and prevention strategies of ALT elevation were explored to provide theoretical basis for further clinical diagnosis and treatment of asymptomatic ALT elevation.Methods1.By investigating the abnormal rate of ALT and the prevalence of NAFLD in123290 healthy people who had been examined in the health management center of our hospital for four years,and analyzing the correlation between the two,the relationship between the asymptomatic elevation of ALT and NAFLD in healthy people was discussed.2.This paper retrospectively analyzed the causes of ALT elevation in 286 recruits from Henan Province who had been screened and qualified for military service for 10consecutive years,and discussed the mechanism of ALT elevation.3.Through the analysis of the causes of severe heatstroke combined with significant increase of ALT in 45 military academies after intensive exercise(5 km cross-country training),the relationship between the increase of ALT and HSI after intensive exercise was further clarified.Results1.The abnormal rate of ALT was 11.19%and the detection rate of NAFLD was26.7%.The increase of asymptomatic ALT was highly correlated with the occurrence of NAFLD(?~2=8523.585,P<0.001).2.The main causes of asymptomatic ALT elevation in recruits were NAFLD(44.4%)and transient liver injury(38.5%)with an increasing trend year by year.3.The incidence of severe heatstroke combined with acute liver injury caused by 5km cross-country training is as high as 60%.This indicates that the elevation of ALT after intensive exercise is closely related to HSI injury and should be paid attention to and prevented.Conclusion1.NAFLD and HSI are the two main causes of asymptomatic ALT elevation,among which NAFLD is the primary cause of asymptomatic ALT elevation,and its weight is larger and more common.2.HSI caused by environmental stress and vigorous exercise is the second cause of asymptomatic ALT elevation.It is only related to the stress response of special population to special environment when recruits are enrolled in the army or during vigorous exercises such as military training.Therefore,we should pay close attention to HSI in military health examination and physical training.