Southern medical journalSep 10, 2009

Higher liver enzyme levels in current NFL players linked to heart and metabolism risk factors, obesity, and insulin resistance

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Updated Mar 31, 2026

Abstract

An elevated alanine aminotransferase (ALT) was significantly correlated with multiple cardiometabolic syndrome markers in current NFL players.

ALT levels greater than or equal to 30 IU/L were linked to higher mean body mass index (BMI).
Increased ALT was associated with blood pressure readings of 130/85 mm Hg or higher.
Players with elevated ALT often exhibited waist circumferences of 100 cm or more.
The triglycerides-to-HDL ratio was greater than 3.5 in players with elevated ALT.
Linemen showed a significantly higher prevalence of elevated ALT levels.

Simplified

OBJECTIVES: Media reports suggest increased cardiovascular mortality in former National Football League (NFL) players. We previously demonstrated that current heavier players already have cardiometabolic syndrome markers: blood pressure (BP) >or=130/85 mm Hg, fasting glucose >or=100 mg/dL, triglycerides >or=150 mg/dL, waist circumference >or=100 cm, and high-density lipoprotein (HDL) <or=40 mg/dL.

METHODS: A prospective study including 69 of 91active players (76%) from one NFL team was performed. We evaluated the presence of an elevated alanine aminotransferase (ALT) in the players. We also analyzed the association of an increased ALT with cardiometabolic syndrome markers, waist-to-height ratio, and triglyceride-to-HDL ratio in current NFL players.

RESULTS: ALT >or=30 IU/L was significantly correlated with mean body mass index (BMI), BMI >or=30 kg/m, BP >or=130/85 mm Hg, waist circumference >or=100 cm, and triglycerides-to-HDL ratio >3.5. An elevated ALT was significantly more common in linemen.

CONCLUSIONS: An elevated ALT was significantly associated with visceral obesity, hypertension, cardiometabolic syndrome markers, and insulin resistance in current NFL players.

Higher liver enzyme levels in current NFL players linked to heart and metabolism risk factors, obesity, and insulin resistance

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