Abstract
BACKGROUND: Liver chemistries are used to measure liver function or damage, and it is vital to differentiate between the changes due to aging versus other causes. The literature has also reported a decline in serum alanine transaminase (ALT) in older age independent of other factors. In this study, we seek to (1) evaluate liver chemistries in healthy community-dwelling older adults, and (2) investigate the associations with age, sex, use of statins, and other factors. METHODS: This cross-sectional study included 400 older adults aged ≥ 65 years with normal nutritional status and who took part as a non-randomized reference group in the Strengthening Health In ELDerly through nutrition (SHIELD) study. Blood samples were analyzed for ALT, aspartate transaminase (AST), albumin, total bilirubin, alkaline phosphatase (ALP), total protein, and globulin. Analysis of variance and multiple linear regression models were used to evaluate the desired associations. RESULTS: Mean values of all the liver chemistries were within normal laboratory reference ranges for both sex and age categories. Males had higher ALT, albumin, and total bilirubin than females (all P ≤ 0.023), whereas females had higher ALP and globulin than males (both P ≤ 0.015). Participants aged 65 to < 75 years had higher ALT and lower total bilirubin than those aged ≥ 75 years (both P ≤ 0.020). There was a significant relationship between ALP and intensity of statin therapy (P = 0.023), in which high-intensity statin therapy had significantly higher ALP than low-intensity statin therapy (P = 0.045). However, these values were still within the normal range for ALP. CONCLUSIONS: Liver chemistries in community-dwelling older adults with normal nutritional status were within the normal reference range used for adults. There were small but statistically significant differences with age, sex, and intensity of statin therapy. ALT declined with age, and further prospective studies are required to determine cut-offs for increased risk of adverse clinical outcomes. TRIAL REGISTRATION: NCT03240952. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-025-06329-2.