{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T20:41:40Z","timestamp":1793306500164,"version":"4.5.0"},"reference-count":25,"publisher":"Baishideng Publishing Group Inc.","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World J Gastroenterol"],"abstract":"<jats:p>BACKGROUND<\/jats:p>\n          <jats:p>Within the normal range, elevated alanine aminotransferase (ALT) levels are associated with an increased risk of metabolic dysfunction-associated fatty liver disease (MAFLD).<\/jats:p>\n          <jats:p>AIM<\/jats:p>\n          <jats:p>To investigate the associations between repeated high-normal ALT measurements and the risk of new-onset MAFLD prospectively.<\/jats:p>\n          <jats:p>METHODS<\/jats:p>\n          <jats:p>A cohort of 3553 participants followed for four consecutive health examinations over 4 years was selected. The incidence rate, cumulative times, and equally and unequally weighted cumulative effects of excess high-normal ALT levels (ehALT) were measured. Cox proportional hazards regression was used to analyse the association between the cumulative effects of ehALT and the risk of new-onset MAFLD.<\/jats:p>\n          <jats:p>RESULTS<\/jats:p>\n          <jats:p>A total of 83.13% of participants with MAFLD had normal ALT levels. The incidence rate of MAFLD showed a linear increasing trend in the cumulative ehALT group. Compared with those in the low-normal ALT group, the multivariate adjusted hazard ratios of the equally and unequally weighted cumulative effects of ehALT were 1.651 [95% confidence interval (CI): 1.199-2.273] and 1.535 (95%CI: 1.119-2.106) in the third quartile and 1.616 (95%CI: 1.162-2.246) and 1.580 (95%CI: 1.155-2.162) in the fourth quartile, respectively.<\/jats:p>\n          <jats:p>CONCLUSION<\/jats:p>\n          <jats:p>Most participants with MAFLD had normal ALT levels. Long-term high-normal ALT levels were associated with a cumulative increased risk of new-onset MAFLD.<\/jats:p>","DOI":"10.3748\/wjg.v30.i10.1346","type":"journal-article","created":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T12:50:24Z","timestamp":1710420624000},"page":"1346-1357","source":"Crossref","is-referenced-by-count":25,"title":["Cumulative effects of excess high-normal alanine aminotransferase levels in relation to new-onset metabolic dysfunction-associated fatty liver disease in China"],"prefix":"10.3748","volume":"30","author":[{"given":"Jing-Feng","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhuo-Qing","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao-Shuang","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"You-Xiang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miao","family":"Xing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Qin","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su-Ying","family":"Ding","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2060","published-online":{"date-parts":[[2024,3,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2021.11.038"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2019.11.312"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1210\/clinem\/dgac428"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-022-00635-5"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2021.02.030"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2021-056260"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1111\/liv.15259"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.eprac.2022.03.016"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v29.i45.5962"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.7717\/peerj.13022"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1186\/s12887-018-1202-z"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1111\/hepr.12456"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.2196\/36997"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.cn112338-20210809-00621"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v29.i43.5804"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.5604\/01.3001.0010.7538"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2022.0064"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1186\/s12876-020-1165-z"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1002\/hep4.1593"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.1002\/hep4.1794"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.1007\/s11356-019-07066-x"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000388"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1111\/liv.14251"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1002\/hep.22109"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1111\/liv.13705"}],"container-title":["World Journal of Gastroenterology"],"original-title":[],"link":[{"URL":"https:\/\/www.wjgnet.com\/1007-9327\/full\/v30\/i10\/1346.htm","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.wjgnet.com\/1007-9327\/full\/v30\/i10\/1346.htm","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,14]],"date-time":"2024-03-14T12:51:00Z","timestamp":1710420660000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.wjgnet.com\/1007-9327\/full\/v30\/i10\/1346.htm"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,14]]},"references-count":25,"journal-issue":{"issue":"10"},"URL":"https:\/\/doi.org\/10.3748\/wjg.v30.i10.1346","relation":{},"ISSN":["1007-9327"],"issn-type":[{"value":"1007-9327","type":"print"}],"subject":[],"published":{"date-parts":[[2024,3,14]]}}}