The association of alanine transaminase with aging, frailty, and mortality

J Gerontol A Biol Sci Med Sci. 2010 Jul;65(7):712-7. doi: 10.1093/gerona/glq082. Epub 2010 May 24.


The relationships between blood tests of liver function and injury (alanine transaminase [ALT], gamma-glutamyl transferase, bilirubin, and albumin) with age, frailty, and survival were investigated in 1,673 community-dwelling men aged 70 years or older. ALT was lower in older participants. Those participants with ALT below the median at baseline had reduced survival (hazard ratio 2.10, 95% confidence interval [CI] 1.53-2.87) up to 4.9 years. Older age, frailty, low albumin, low body mass index, and alcohol abstinence also were associated with reduced survival, with age and frailty being the most powerful predictors. Low ALT was associated with frailty (odds ratio 3.54, 95% CI 2.45-5.11), and the relationship between ALT and survival disappeared once frailty and age were included in the survival analysis. Low ALT activity is a predictor of reduced survival; however, this seems to be mediated by its association with frailty and increasing age. ALT has potential value as a novel biomarker of aging.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Aging / blood*
  • Aging / physiology
  • Alanine Transaminase / blood*
  • Alcohol Drinking / mortality
  • Analysis of Variance
  • Biomarkers / blood
  • Body Mass Index
  • Confidence Intervals
  • Frail Elderly*
  • Humans
  • Kaplan-Meier Estimate
  • Liver Function Tests
  • Male
  • Mortality
  • Multivariate Analysis
  • Odds Ratio
  • Proportional Hazards Models
  • Serum Albumin / analysis


  • Biomarkers
  • Serum Albumin
  • Alanine Transaminase