Fast food based hyper-alimentation can induce rapid and profound elevation of serum alanine aminotransferase in healthy subjects

Stergios Kechagias ¹, Åsa Ernersson ¹, Olof Dahlqvist ¹, Peter Lundberg ¹, Torbjörn Lindström ¹ and Fredrik H Nystrom ^1*

¹ Linkoping University, Sweden

^* To whom correspondence should be addressed. E-mail: fredrik.nystrom{at}lio.se.

Accepted 28 October 2007

Abstract

Objective To study the effect of fast food-based hyper-alimentation on liver enzymes and hepatic triglyceride content (HTGC).

Design Prospective interventional study with parallel control group.

Setting University Hospital of Linkoping, Sweden. Participants 12 healthy men and six healthy women with a mean (SD) age of 26 (6.6) years and a matched control group.

Intervention Subjects in the intervention group aimed for a body weight increase of 5-15% by eating at least two fast food-based meals a day with the goal to double the regular caloric intake in combination with adoption of a sedentary lifestyle for four weeks.

Main outcome measures Weekly changes of serum aminotransferases and HTGC measured by proton nuclear magnetic resonance-spectroscopy at baseline and after the intervention.

Results Subjects in the intervention group increased from 67.6 (9.1) kg to 74.0 (11) kg in weight (p<0.001). Serum ALT increased from 22.1 (11.4) U/l at study start to an individual mean maximum level of 97 (103) U/l (range 19.4-447 U/l). Eleven of the 18 subjects persistently showed ALT above reference limits (women >19U/l, men >30U/l) during the intervention. Sugar (mono- and disaccharides) intake during week three correlated with the maximal ALT/baseline ALT-ratio (r=0.62, p=0.006). HTGC increased from 1.1 (1.9) % to 2.8 (4.8) %, although this was not related to the increase in ALT levels. ALT levels were unchanged in controls.

Conclusion Hyper-alimentation per se can induce profound ALT elevations in less than four weeks. Our study clearly shows that in the evaluation of subjects with elevated ALT the medical history should include not only questions about alcohol intake but also explore whether recent excessive food intake has occurred.

Keywords: aminotransferase, human, liver steatosis, obesity

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