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Rise in ALT After Weight Loss Is No Cause for Alarm


 

PHOENIX — Increases in liver enzymes after substantial weight loss are common, transient, and not cause for alarm, suggest study results presented at the annual scientific meeting of the Obesity Society.

Dr. James W. Anderson assessed liver function tests in 91 obese and 94 severely obese patients who were engaged in a rapid weight loss program at the University of Kentucky, Lexington, where he is medical director of the Health Management Resources weight loss program.

About a quarter of both groups had elevated alanine aminotransferase (ALT) levels at baseline. Mean ALT levels increased within 3-6 weeks of starting the program in nearly all patients. By 16 weeks, however, ALT levels had returned to normal in 98% of the population.

The 91 obese patients in the study had a baseline body mass index of 42 mg/m

Less than half, 47%, of the 94 severely obese individuals were women, and the group was slightly younger (average age, 43 years). This cohort started with a baseline BMI of 53 kg/m

In 70 severely obese patients with baseline ALT values of 40 U/L or less, those values rose from 25 U/L to 60 U/L at 6 weeks, fell to 30 U/L at 16 weeks, and were below baseline at 40 weeks. Mean peak and final values in this group were 81 U/L and 24 U/L, respectively. Another 24 severely obese patients had abnormal initial ALT values that increased from 61 U/L to 81 U/L at 2 weeks, then fell to 34 U/L by 16 weeks. Mean peak and final values in this group were 97 U/L and 28 U/L, respectively. A similar pattern was seen in the obese group, but the changes were not as dramatic. Initial and final ALT values were 33 U/L and 29 U/L, respectively, said Dr. Anderson, who disclosed no conflicts of interest.

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