Metabolic dysfunction-associated steatotic liver disease: The question of long-term high-normal alanine aminotransferase as a screening test

doi:10.3748/wjg.v30.i42.4576

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World Journal of Gastroenterology

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1007-9327

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World J Gastroenterol. Nov 14, 2024; 30(42): 4576-4582
Published online Nov 14, 2024. doi: 10.3748/wjg.v30.i42.4576

Metabolic dysfunction-associated steatotic liver disease: The question of long-term high-normal alanine aminotransferase as a screening test

Terence N Moyana

Terence N Moyana, Department of Pathology and Laboratory Medicine, University of Ottawa and The Ottawa Hospital, Ottawa K1H 8L6, Ontario, Canada

Author contributions: As the sole author, Moyana TN is responsible for all aspects of the work, including conception, design, research, writing, and finalization of the manuscript.

Conflict-of-interest statement: The authors declare that they have no conflict of interest.

Corresponding author: Terence N Moyana, FRCPC, MD, Full Professor, Department of Pathology and Laboratory Medicine, University of Ottawa and The Ottawa Hospital, 501 Smyth Road, General Campus, Ottawa K1H 8L6, Ontario, Canada. tmoyana@eorla.ca

Received: July 17, 2024
Revised: September 26, 2024
Accepted: October 9, 2024
Published online: November 14, 2024
Processing time: 105 Days and 10.8 Hours

Core Tip

Core Tip: High normal alanine aminotransferase (ALT) has potential utility in screening for new-onset metabolic dysfunction-associated steatotic liver disease (MASLD). In view of its biochemistry, the upper limit of normal for ALT has to be interpreted with caution since it can be influenced by various methodologic and physiologic factors. Its utility as a screening tool could be enhanced by combining it with other serum biomarkers, cardiometabolic risk factors, imaging techniques and MASLD genetics to create predictive nomograms or machine learning classifiers.