Association of AST/ALT (De Ritis) ratio with sarcopenia in a Chinese population of community-dwelling elderly

Cheng Wu; Quan Wang; Chun-Ya Zhou; Hui-Xian Sun; Yu-Shuang Lin; Xin-Feng Jiao; Xiang Lu; Jin-Shui Xu; Zheng-Kai Shen; Yan Guo; Wei Gao

doi:10.1016/j.heliyon.2023.e20427

Association of AST/ALT (De Ritis) ratio with sarcopenia in a Chinese population of community-dwelling elderly

Heliyon. 2023 Sep 28;9(10):e20427. doi: 10.1016/j.heliyon.2023.e20427. eCollection 2023 Oct.

Authors

Cheng Wu¹, Quan Wang^{1

2}, Chun-Ya Zhou³, Hui-Xian Sun¹, Yu-Shuang Lin¹, Xin-Feng Jiao¹, Xiang Lu¹, Jin-Shui Xu⁴, Zheng-Kai Shen⁴, Yan Guo², Wei Gao⁵

Affiliations

¹ Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China.
² Department of Geriatrics, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
³ Department of Rheumatology, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China.
⁴ Jiangsu Province Center for Disease Control and Prevention, Nanjing, China.
⁵ Department of Geriatrics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China.

Abstract

Background: The aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio, also known as De Ritis ratio, has been reportedly associated with malnutrition which plays a crucial role in sarcopenia. The aim of this study was to examine the relationship between AST/ALT ratio and sarcopenia in the Chinese community-dwelling elderly.

Methods: A cross-sectional study with 2751 participants (1343 men and 1408 women) aged ≥60 years was performed. Appendicular skeletal muscle mass index (ASMI), grip strength, and gait speed were measured to diagnose sarcopenia according to the latest Asian Working Group for Sarcopenia (AWGS) consensus. The association of AST/ALT ratio with sarcopenia was examined using logistic regression analysis.

Results: The prevalence of sarcopenia in the present study was 4.4%. AST/ALT ratio was higher in the sarcopenia group than in the non-sarcopenia group (1.30 ± 0.33 vs. 1.16 ± 0.62, P = 0.010). AST/ALT ratio was negatively correlated with the components of sarcopenia, including ASMI, grip strength, and gait speed. Logistic regression analysis indicated that high AST/ALT ratio (>1.20) was associated with increased risk of sarcopenia even after adjustment for potential confounders (adjusted OR = 2.33, 95%CI = 1.48-3.68, P < 0.001). Stratification analyses indicated that the association of high AST/ALT ratio with high risk of sarcopenia was more significant in males and the elderly with ≥70 years.

Conclusions: Our findings demonstrate that high AST/ALT ratio is associated with increased risk of sarcopenia in a Chinese population of community-dwelling elderly.

Keywords: AST/ALT ratio; Community-dwelling; Elderly; Sarcopenia.