Low ALT blood levels predict long-term all-cause mortality among adults. A historical prospective cohort study.

BACKGROUND: Increased blood levels of alanine amino transferase (ALT, also known as SGPT; serum glutamic pyruvic transaminase) serve as a marker of liver injury by various mechanisms. Less is known about the clinical implications associated with low-normal ALT levels. Previous studies showed low ALT levels to be associated with poor long-term outcomes among elderlies, serving as a biomarker for increased incidence of frailty and subsequent risk of mortality. However, it has not been determined yet whether low-normal ALT values might be predictive of frailty and mortality in younger, middle-aged adults. METHODS: We conducted a historical prospective cohort analysis. RESULTS: A total of 23,506 adults with ALT levels within the normal range, at the mean age of 48 ± 11 years, participating in an annual screening program for preventive medicine, were followed-up for a median period of 8.5 years during which 638 died. Low-normal ALT values (serum ALT activity <17IU/L) were found to be predictive for increased risk of all-cause mortality (HR=1.6; 95% CI 1.34-1.92; p<0.001). Statistically significant correlation was demonstrated even after applying a multifactorial model correction for age, gender, eGFR, low albumin, arterial hypertension, diabetes mellitus and ischemic heart disease. CONCLUSIONS: We suggest that low-normal ALT values may serve as an independent predictive marker for increased long-term mortality in middle-aged adults.

Longitudinal study of periodontal condition in students of the Dental School the University of Buenos Aires Argentina.

The aim of the present study was to describe, clinically and radiographically, the gingivoperiodontal condition of students (young adults) entering the Dental School and reassess it 2 years later. Four hundred and seventy-five students, 147 male and 328 female (mean: 19.66 years) were studied (Initial examination: IE); two years later, 240 students 76 male and 164 female were reevaluated (Final examination: FE). The clinical examination include Plaque Index (P1I), Gingival Index (GI), Bleeding on Probing (BOP), Probing Pocket Depth (PPD), and Attachment Level (AL). Alveolar bone level was measured on bite wing radiographs. At the IE, 46.5% of the sites had no visual signs of inflammation and 65.3% did not bleed on probing, however 91% of the students had at least one site with BOP. (Prevalence). Of the total sites probed 99.47% had crevices between 1 to 4 mm. 92% had AL between 0 to 1 mm. And only 7.9% had AL > 1 mm. 49.6% of the students had at least one site with AL > 1 mm. Prevalence of alveolar bones loss > 2 mm. was 2.95% and in no case measurements exceeded 3 mm. Distal of teeth 16 and 36 showed the highest P1I, GI, PPD and AL, therefore these teeth showed the highest risk of pathology in the population studied. In the final examination 70.5% of the sites had GI 0 and 73% did not bleed on probing. 90.4% of the students had at least one site with BOP. No statistically significant difference in PPD nor in AL was found between IE and FE. In this population of young adults prevalence of gingivitis was high but severity was low. Prevalence of loss of attachment was near 50% but only 7.9% of the sites had AL > 1 mm. After studying dentistry for two years the prevalence of gingivitis was similar but the severity was lower. Periodontal condition was not substantially modified.