Material and Method: A cross-sectional study on 2,585 Thais was conducted. Blood pressure, waist circumference, fasting plasma glucose, triglyceride, HDL-cholesterol, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP) were measured. MS was diagnosed using NCEP/ATP III criteria with modified waist circumference for Asian. The association between MS with elevated liver enzymes was performed using logistic regression.

Results: Twenty-seven percent of the subjects were found to have MS. The MS group had significantly higher mean AST, ALT, and ALP levels than the non-MS group (mean (SD) for AST 29.86 (18.97), 24.08 (12.71); ALT 38.39 (29.14), 24.38 (18.57); and ALP 73.45 (27.09), 65.72 (21.27) for MS and non-MS, respectively, p < 0.05). MS was significantly associated with elevated liver enzymes. The adjusted odds ratios (OR) were 2.2 (95% confidence interval (CI): 1.6-2.9), 2.3 (95% CI: 1.8-3.0), and 2.2 (95% CI: 1.1-4.2) for elevated AST, ALT, and ALP, respectively. ALT/AST ratio of > 1 was significantly associated with MS in both genders (adjusted ORs: 1.72 (95% CI: 1.28-2.32) for men and 2.30 (95% CI: 1.68-3.16) for women).

Conclusion: There is a strong association between metabolic syndrome and elevated liver enzymes. Further study is needed to investigate the long-term sequelae of liver abnormalities in those with metabolic syndrome in Thai population.

Keywords: Metabolic syndrome, Elevated liver enzymes