Table 3.

Association between change in risk factor status from Wave 1 (W1) to Wave 2 (W2) and risk of elevated ALT^a among participants who had normal ALT levels at Wave 1. (N= 1,217)

	Model 1b	Model 2c	Model 3d
	OR (95% CI)	OR (95% CI)	OR (95% CI)
Sex
Female (n= 959)	1.00	1.00	1.00
Male (n= 258)	1.1 (0.7 – 1.8)	1.2 (0.7 – 1.9)	1.3 (0.8 – 2.2)
Age
≤ 39 (n = 406)	3.7 (1.5 – 8.8)**	3.7 (1.5 – 9.0)**	4.2 (1.6 – 10.8)**
40–59 (n = 610)	3.7 (1.6 – 8.8)**	3.6 (1.5 –8.5)**	3.8 (1.6 – 9.3)**
≥ 60 (n= 201)	1.00	1.00	1.00
BMIe (from W1 – W2)
Remained Normal (n= 390)	1.00	1.00	1.00
Weight Lossf (n= 92)	1.5 (0.6 – 4.0)	1.6 (0.6 – 4.3)	1.6 (0.6 – 4.3)
Remained Overweight (n= 379)	2.4 (1.3 – 4.3)**	2.5 (1.4 – 4.6)**	2.5 (1.4 – 4.6)**
Remained Obese (n= 150)	2.8 (1.4 – 5.7)**	3.0 (1.5 – 6.2)**	3.1 (1.5 – 6.3)**
Weight Gaing (n= 201)	4.2(2.2 – 7.7)**	4.0 (2.2 – 7.5)**	4.1 (2.2 – 7.6)*
Diabetesh (from W1 – W2)
Never Diabetic (n= 1,081)	1.00	1.00	1.00
Remained Diabetic (n= 72)	1.2 (0.5 – 2.6)	1.7 (0.7 – 4.0)	1.7 (0.7 – 4.0)
Developed Diabetes (n= 64)	2.5 (1.3 – 4.9)**	2.7 (1.3 – 5.4)**	2.7 (1.3 – 5.4)**
Metabolic Syndromei (MS) (from W1 – W2)
Never had MS (n= 648)	1.00	1.00	1.00
Remained with MS (n= 228)	1.8 (1.0 – 3.0)*	1.8 (1.0 – 3.4)	1.8 (1.0 – 3.4)
Developed MS (n= 260)	2.7 (1.7 – 4.3)**	2.3 (1.4 – 3.8)**	2.2 (1.3 – 3.7)**
No Longer have MS (n= 81)	2.2 (1.1 – 4.6)*	2.3 (1.1 – 5.0)*	2.2 (1.0 – 4.9)*

^aElevated alanine aminotransferase (ALT) was defined as ALT > 40 IU/L for males and females.

^bModel 1: Unadjusted

^cModel 2: Adjusted for age, sex, BMI

^dModel 3: Adjusted for age, sex, BMI, alcohol, education

^eBody mass index (BMI) was defined as normal <25 kg/m², overweight between 25–30 kg/m², and obese ≥ 30 kg/m².

^fWeight loss was defined as any of the following changes in BMI status from W1 to W2: obese (W1) – overweight (W2), obese (W1) – normal (W2), or overweight (W1) – normal (W2)

^gWeight gain was defined as any of the following changes in BMI status from W1 to W2: normal (W1) – overweight (W2), normal (W1) – obese (W2), overweight (W1) – obese (W2)

^hDiabetes status was determined based on participant’s medical history, current use of diabetes medications, and/or a plasma glucose level > 125 mg/dL.

ⁱWe defined Metabolic Syndrome according to the Third Report of the National Cholesterol Education Program’s Adult Treatment Panel (ATP III).

^*P < 0.01 for test of null hypothesis that the odds ratio is equal to the odds ratio in the reference category.

^**P < 0.05 for test of null hypothesis that the odds ratio is equal to the odds ratio in the reference category.