Low ALT values amongst hospitalized patients are associated with increased risk of hypoglycemia and overall mortality: a retrospective, big-data analysis of 51 831 patients.

E Itelman, A Segev, L Ahmead, E Leibowitz, M Agbaria, C Avaky, L Negro, G Shenhav-Saltzman, Y Wasserstrum, G Segal

QJM : monthly journal of the Association of Physicians 2022 Jan 09

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Sarcopenia and frailty influence clinical patients' outcomes. Low alanine aminotransferase (ALT) serum activity is a surrogate marker for sarcopenia and frailty. In-hospital hypoglycemia is associated, also with worse clinical outcomes. We evaluated the association between low ALT, risk of in-hospital hypoglycemia and subsequent mortality. This was a retrospective cohort analysis. We included patients hospitalized in a tertiary hospital between 2007 and 2019. Patients' data were retrieved from their electronic medical records. The cohort included 51 831 patients (average age 70.88). The rate of hypoglycemia was 10.8% (amongst diabetics 19.4% whereas in non-diabetics 8.3%). The rate of hypoglycemia was higher amongst patients with ALT < 10 IU/l in the whole cohort (14.3% vs. 10.4%, P < 0.001) as well as amongst diabetics (24.6% vs. 18.8%, P < 0.001). Both the overall and in-hospital mortality were higher in the low ALT group (57.7% vs. 39.1% P < 0.001 and 4.3% vs. 3.2%, P < 0.001). A propensity score matching, after which a regression model was performed, showed that patients with ALT levels < 10 IU/l had higher risk of overall mortality (HR = 1.21, CI 1.13-1.29, P < 0.001). Low ALT values amongst hospitalized patients are associated with increased risk of in-hospital hypoglycemia and overall mortality. © The Author(s) 2020. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Citation

E Itelman, A Segev, L Ahmead, E Leibowitz, M Agbaria, C Avaky, L Negro, G Shenhav-Saltzman, Y Wasserstrum, G Segal. Low ALT values amongst hospitalized patients are associated with increased risk of hypoglycemia and overall mortality: a retrospective, big-data analysis of 51 831 patients. QJM : monthly journal of the Association of Physicians. 2022 Jan 09;114(12):843-847