Abstract
BackgroundThe aim of the present study was to examine how liver markers are associated with insulin resistance in Japanese community-dwelling adults.MethodsThis cross-sectional study included 587 men aged 58 ± 14 (mean ± standard deviation; range, 20–89) years and 755 women aged 60 ± 12 (range, 21–88) years. The study sample consisted of 998 (74.4%) non-obese [body mass index (BMI) <25.0 kg/m2] and 344 (25.6%) overweight (BMI ≥25 kg/m2) subjects. Insulin resistance was defined by homeostasis model assessment of insulin resistance (HOMA-IR) of at least 2.5, and HOMA-IR and potential confounders were compared between the groups. Areas under the curve (AUC) of the receiver operating characteristic curves (ROC) were used to compare the power of these serum markers.ResultsIn non-obese subjects, the best marker of insulin resistance was alanine aminotransferase (ALT)/aspartate aminotransferase (AST) ratio of 0.70 (95% confidence interval (CI), 0.63-0.77). In overweight subjects, AUC values for the ALT/AST ratio and ALT were 0.66 (0.59-0.72) and 0.66 (0.59-0.72), respectively. Multiple linear regression analyses for HOMA-IR showed that ALT/AST ratios were independently and significantly associated with HOMA-IR as well as other confounding factors in both non-obese and overweight subjects. The optimal cut-off point to identifying insulin resistance for these markers yielded the following values: ALT/AST ratio of ≥0.82 in non-obese subjects and ≥1.02 in overweight subjects. In non-obese subjects, the positive likelihood ratio was greatest for ALT/AST ratio.ConclusionsIn non-obese Japanese adults, ALT/AST ratio may be the best reliable marker of insulin resistance.
Highlights
The aim of the present study was to examine how liver markers are associated with insulin resistance in Japanese community-dwelling adults
The optimal cut-off point to identifying insulin resistance for these markers yielded the following values: ALT/AST ratio of ≥0.82 in nonobese subjects, and ≥1.02 in overweight
In the present study, we examined whether liver markers (e.g., gammaglutamyl transferase (GGT), ALT, AST, and ALT/AST ratio) as well as gender, age, BMI, smoking status, alcohol consumption, systolic blood pressure (SBP), lipid profiles, uric acid, and serum high molecular weight (HMW) adiponectin were associated with insulin resistance in Japanese adults, categorized by body mass index
Summary
The aim of the present study was to examine how liver markers are associated with insulin resistance in Japanese community-dwelling adults. Many studies have demonstrated that alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gammaglutamyl transferase (GGT) levels independently predict type 2 diabetes [6,7,8,9,10], metabolic syndrome [11,12,13,14], and CVD [8]. These markers have been shown to be associated with indirect measurements of insulin resistance including fasting insulin levels [14] and HOMA-IR [10,15,16,17]. It is important for us to be able to evaluate insulin resistance by measuring the liver markers which are inexpensive and routinely measured in clinical setting
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