{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T14:51:01Z","timestamp":1791643861192,"version":"4.3.4"},"reference-count":32,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Astellas Pharma Inc."}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Women's Health"],"published-print":{"date-parts":[[2026,11,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>We estimated the prevalence of elevated liver-associated enzymes (LAEs) in a nationally representative sample of women aged 40\u201365 years in the United States, overall and by menopausal status or by metabolic dysfunction-associated steatotic liver disease (MASLD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This descriptive study used cross-sectional data from the National Health and Nutrition Examination Survey collected from 1999\/2000 to 2017\/March 2020. The primary study endpoint was the weighted prevalence of elevated LAEs, measured by alanine aminotransferase (ALT) or aspartate aminotransferase (AST) &gt;3\u00d7 the upper limit of normal (ULN). Prespecified secondary endpoints included the prevalence of elevated LAEs by different definitions and by menopause and MASLD status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>The study included 11,443 women aged 40\u201365 years (mean age 51.7 years) from surveys representing the general population: 53.3% postmenopausal, 33.8% premenopausal, and 12.9% with unknown menopausal status. The prevalence of MASLD was estimated at 29.5% (95% confidence interval [CI]: 27.7\u201331.4); this was higher in postmenopausal women (34.4%, 95% CI: 32.0\u201336.9) than premenopausal women (22.7%, 95% CI: 20.2\u201325.4). The estimated prevalence of ALT or AST &gt;3\u00d7 ULN was 0.87% (95% CI: 0.68\u20131.11); this was similar for premenopausal (0.84%, 95% CI: 0.48\u20131.36) and postmenopausal (0.91%, 95% CI: 0.67\u20131.21) women, but higher for women with MASLD (1.50%, 95% CI: 0.87\u20132.40) than those without MASLD (0.25%, 95% CI: 0.09\u20130.56).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This study provides prevalence estimates of elevated LAEs in middle-aged women in the US general population. MASLD was common, and ALT or AST &gt;3\u00d7 ULN was more prevalent in women with than without MASLD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15409996261458973","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T06:57:02Z","timestamp":1781593022000},"page":"1091-1097","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Prevalence of Elevated Liver-Associated Enzymes in Women Aged 40\u201365 Years in the United States Overall, and With and Without Metabolic Dysfunction\u2014Associated Steatotic Liver Disease"],"prefix":"10.1177","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-6203-3176","authenticated-orcid":false,"given":"Yadong Adam","family":"Cui","sequence":"first","affiliation":[{"name":"Epidemiology, RAPV, Astellas Pharma Global Development, Northbrook, Illinois, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Storfer-Isser","sequence":"additional","affiliation":[{"name":"Formerly of Real-World Data Science, Astellas Pharma Global Development, Northbrook, Illinois, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bosny","family":"Pierre-Louis","sequence":"additional","affiliation":[{"name":"Safety Science Statistics, Astellas Pharma Global Development, Northbrook, Illinois, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karla","family":"Martins","sequence":"additional","affiliation":[{"name":"Medical Affairs, Astellas Pharma Europe Ltd., Addlestone, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Snijder","sequence":"additional","affiliation":[{"name":"Real World Informatics, Astellas Pharma Europe B.V., Leiden, The Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Han","sequence":"additional","affiliation":[{"name":"R&amp;D Analytics Innovation, R&amp;DX, Astellas Pharma US, Northbrook, Illinois, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Chin-Kon-Sung","sequence":"additional","affiliation":[{"name":"Global Medical Safety, RAPV, Astellas Pharma Europe B.V., Leiden, The Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noah Jamie","family":"Robinson","sequence":"additional","affiliation":[{"name":"Epidemiology, RAPV, Astellas Pharma A.G., Wallisellen, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200004273421707"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra052270"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13105-023-00991-z"},{"key":"e_1_3_3_5_1","volume-title":"Drug-induced liver injury (DILI): Current status and future directions for drug development and the post-market setting","author":"CIOMS","year":"2020","unstructured":"4.CIOMS. 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