Editorial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 7, 2024; 30(25): 3132-3139
Published online Jul 7, 2024. doi: 10.3748/wjg.v30.i25.3132
Alanine aminotransferase as a risk marker for new-onset metabolic dysfunction-associated fatty liver disease
Di Wang, Bing-Yan Zhou, Lei Xiang, Xu-Yong Chen, Jie-Xiong Feng
Di Wang, Bing-Yan Zhou, Lei Xiang, Xu-Yong Chen, Jie-Xiong Feng, Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
Co-first authors: Di Wang and Bing-Yan Zhou.
Author contributions: Wang D drafted the manuscript; Zhou BY and Xiang L reviewed the literature; Feng JX conceived the idea and coordinated the manuscript; Chen XY and Feng JX approved the final version of the article.
Supported by National Natural Science Foundation of China, No. 81873541.
Conflict-of-interest statement: There is no conflict of interest to declare.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jie-Xiong Feng, MD, PhD, Chief Doctor, Professor, Department of Pediatric Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Ave, Wuhan 430030, Hubei Province, China. 2002tj0515@hust.edu.cn
Received: March 6, 2024
Revised: May 7, 2024
Accepted: June 13, 2024
Published online: July 7, 2024
Processing time: 117 Days and 4.1 Hours
Abstract

In this editorial, we comment on the article by Chen et al. Metabolic dysfunction-associated fatty liver disease (MAFLD) is a global public health burden whose incidence has risen concurrently with overweight and obesity. Given its detrimental health impact, early identification of at-risk individuals is crucial. MAFLD diagnosis is based on evidence of hepatic steatosis indicated by liver biopsy, imaging, or blood biomarkers, and one of the following conditions: Overweight/ obesity, type 2 diabetes mellitus, or metabolic dysregulation. However, in large-scale epidemiological studies, liver biopsies are not feasible. The application of techniques such as ultrasonography, computed tomography, magnetic resonance imaging, and magnetic resonance spectroscopy is restricted by their limited sensitivity, low effectiveness, high costs, and need for specialized software. Blood biomarkers offer several advantages, particularly in large-scale epidemiological studies or clinical scenarios where traditional imaging techniques are impractical. Analysis of cumulative effects of excess high-normal blood alanine aminotransferase (ALT) levels of blood ALT levels could facilitate identification of at-risk patients who might not be detected through conventional imaging methods. Accordingly, investigating the utility of blood biomarkers in MAFLD should enhance early detection and monitoring, enabling timely intervention and management and improving patient outcomes.

Keywords: Nonalcoholic fatty liver disease; Metabolic dysfunction-associated fatty liver disease; Alanine aminotransferase; Screening; Risk marker

Core Tip: This editorial discusses the article by Chen et al regarding the association between high-normal alanine aminotransferase (ALT) levels and the onset of metabolic dysfunction-associated fatty liver disease (MAFLD) in China. As an indicator of liver function, ALT could be considered a marker of the presence of MAFLD. Therefore, tracking cumulative ALT levels could enhance early MAFLD detection. Improved detection through ALT tracking could enable timely intervention, thereby enhancing overall health outcomes for individuals at risk of developing this increasingly common liver condition.