Alanine aminotransferase

Method

Serum alanine aminotransferase catalytic activity by clinical enzymatic assay. Whether the reagent was supplemented with pyridoxal phosphate is recorded on the edge where stated, since it shifts measured activity.

The method is part of the endpoint identity. Studies measuring the same quantity by a different method are held as separate endpoints.

Notes

Aspartate aminotransferase is the near-miss: same liver panel, same unit, same direction of benefit, adjacent columns. The distinction is tissue specificity — this enzyme is hepatocyte-specific while AST is also released by skeletal muscle and erythrocytes — and it is not academic: in PMID 41515249 this fell significantly while AST and gamma-glutamyl transferase did not. Merging them makes a liver-specific effect look like a null. Also distinct from CAT:outcome/creatine-kinase, another serum enzyme activity in U/L that indexes muscle damage rather than liver injury, and SIGN INVERSION against serum albumin on the same panel, which improves by RISING.

Findings

3 findings from 2 compounds, strongest first.

• curcumin — decreases

  BLikelyGrade B, Likely. Human evidence, limited replication or design limits.Findingreplicated ×1

  “The overall pooling indicated that curcumin supplementation was significantly associated with reduced ALT [MD (95% CI) of −5.61 (−9.37, −1.85) units/L] with moderate heterogeneity observed (I2 = 64.3%).”

  Study

  meta-analysis

  Dose

  80–3000 mg/day pooled across bioavailability-enhanced forms (80–1000 mg/day), curcumin extracts (1500 mg/day) and turmeric powder (2000–3000 mg/day)

  Population

  Adults with MAFLD (NAFLD/NASH); overall pooling of 14 RCTs, all curcumin forms; liver enzymes were a primary outcome of interest

  Effect -5.61 mean difference, 95% CI -9.37 to -1.85

  An updated meta-analysis of effects of curcumin on metabolic dysfunction-associated fatty liver disease based on available evidence from Iran and Thailand.2023PMID:37037891

• curcumin — decreases

  BLikelyGrade B, Likely. Human evidence, limited replication or design limits.Findingreplicated ×1

  “The results showed that curcumin reduced ALT compared with placebo [SMD = -0.55, 95% CI (-1.01, -0.09), P = 0.02].”

  Study

  meta-analysis

  Participants

  639

  Population

  adults with non-alcoholic fatty liver disease

  Effect -0.55 standardised mean difference, 95% CI -1.01 to -0.09

  Efficacy and safety of dietary polyphenol supplementation in the treatment of non-alcoholic fatty liver disease: A systematic review and meta-analysis.2022PMID:36159792

• berberine — decreases

  DPreliminaryGrade D, Preliminary. Non-human or in vitro only.Finding

  “However, oral administration of BBR not only reversed hepatocyte necrosis, but also decreased the elevated levels of TBA, ALP, TBIL, DBIL, ALT, and AST ( Supplementary Fig. 1A, 1B).”

  Study

  animal · not in humans

  Duration

  7 days

  Population

  C57BL/6J mice with bile duct ligation-induced cholestatic liver injury; serum ALT by automated biochemical analyser

  Gut microbiota-mediated berberine metabolism ameliorates cholestatic liver disease by suppressing 5-hydroxytryptamine production.2026PMID:41087029