Abstract
Emerging data suggest that an increase in serum alanine aminotransferase (ALT) and gamma-glutamyltransferase (GGT) as biomarkers of oxidative stress are associated with increased risk of impaired fasting glucose (IFG). The present study was an investigation of whether an increase in serum ALT and GGT had a combined effect on increasing IFG risk through cross-sectional and longitudinal studies. In the cross-sectional study, data were analyzed from 9937 subjects without diabetes who underwent health check-ups between 1999 and 2001 (baseline data). In the longitudinal study, 6390 subjects were analyzed who had been rechecked between 2009 and 2014, excluding IFG patients from baseline data. In cross-sectional analysis, adjusted odds ratio (OR) of IFG in the fourth quartile of both ALT and GGT was 1.829 (95% confidence interval [CI] 1.545–2.164) compared with the reference group (1st and 2nd quartiles of ALT and GGT). In longitudinal analysis, IFG probability increased gradually with an increase in the circulating levels of ALT and GGT. Adjusted hazard ratios for developing IFG in the fourth quartile of both ALT and GGT was 1.625 (95% CI 1.263–2.091) compared with the reference group (1st and 2nd quartiles). Increased serum ALT and GGT levels are well associated with IFG after potential confounders are adjusted for, and elevated ALT and GGT at the same time can have a combined effect in predicting the development of IFG.
Highlights
Emerging data suggest that an increase in serum alanine aminotransferase (ALT) and gammaglutamyltransferase (GGT) as biomarkers of oxidative stress are associated with increased risk of impaired fasting glucose (IFG)
For the purposes of the cross-sectional study, we excluded patients who had received health examinations from 1999 to 2001 if they met any of the following conditions (n = 30,713): subjects diagnosed with diabetes; subjects with missing fasting blood glucose, serum ALT or serum GGT values; subjects with a history of chronic liver disease, such as hepatitis B or C or liver cirrhosis, or who were taking drugs that influenced liver function; subjects diagnosed with cardiovascular disease or cancer; subjects who had consumed enough alcohol to damage the liver (> 20 g/day in females or > 30 g/day in male
We investigated whether elevated levels of ALT and GGT in the serum were associated with IFG through cross-sectional and longitudinal analysis, and we found that IFG development did significantly increase according to serum ALT and GGT quartiles after we adjusted for established diabetes risk factors, and novel risk factor
Summary
Emerging data suggest that an increase in serum alanine aminotransferase (ALT) and gammaglutamyltransferase (GGT) as biomarkers of oxidative stress are associated with increased risk of impaired fasting glucose (IFG). In cross-sectional analysis, adjusted odds ratio (OR) of IFG in the fourth quartile of both ALT and GGT was 1.829 (95% confidence interval [CI] 1.545–2.164) compared with the reference group (1st and 2nd quartiles of ALT and GGT). Increased serum ALT and GGT levels are well associated with IFG after potential confounders are adjusted for, and elevated ALT and GGT at the same time can have a combined effect in predicting the development of IFG. Emerging data refer to elevated levels of alanine aminotransferase (ALT) and gamma-glutamyltransferase (GGT) in the serum as predictive factors in the development of d iabetes. We hypothesized that elevated levels of ALT and GGT in the serum were associated with the development of IFG, and we further investigated whether elevated levels of ALT and GGT in the blood combined to affect IFG development through cross-sectional and longitudinal studies
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