Abstract
BACKGROUND: Regular physical activity promotes health that can affect liver health, particularly modulating liver enzymes. The objective of this study was to assess the association between physical activities and elevated liver enzyme levels in the population of the Prospective Epidemiological Research Studies of the Iranian Adults (PERSIAN) Guilan cohort study (PGCS). METHODS: This cross-sectional study was conducted on 10,519 individuals from the PGCS population. The demographical and clinical data of participants were collected. The study involved measuring the levels of physical activity and liver enzymes, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and γ-glutamyl transferase (GGT). The study assessed physical activity intensity using standardized classification based on the energy costs of different activities, which was calculated through questionnaires administered in three tertiles. The relationship between physical activity and elevated liver enzymes was examined using the Cochran-Armitage test for trend and logistic regression. RESULTS: The average age of individuals was 51.52±8.90 years, and 53.6% were women. The prevalence of elevated ALT, AST, and GGT decreased with increasing physical activity (p<0.001, 0.010, and <0.001, respectively). According to fully adjusted model, participants with low physical activity levels had higher odds for elevated ALT and GGT compared to the participants with high physical activity levels (OR=1.15, 95% CI: 1.04-1.31 and OR=1.37, 95% CI: 1.16-1.61, respectively) (p<0.05). CONCLUSION: Higher physical activity levels were associated with a lower prevalence of elevated liver enzymes, suggesting that regular physical activity may positively affect liver health.