Does elevated alanine aminotransferase predict components of the metabolic syndrome in polycystic ovarian syndrome?

Abstract

OBJECTIVE: The metabolic syndrome (MS), a classical predictor of type II diabetes, is commonly present in Polycystic Ovarian Syndrome (PCOS) patients. Recent research has also shown that PCOS patients exhibit raised serum levels of Alanine Aminotransferase (ALT). Several recent studies add to the concept of ALT as a predictor of type II diabetes and the MS is ubiquitous in diabetics. The aim of this study was to investigate if ALT predicts components of the MS in PCOS patients.DESIGN: Prospective.MATERIALS AND METHODS: Twenty PCOS patients with a mean age of 26.05 ± 4.77 yrs and body mass index (BMI) of 31.23 ± 7.88 kg/m2 were recruited. Following collection of anthropometric data, all participants underwent a fasting blood sample to quantify fasting glucose, lipids and ALT. Thirteen patients underwent whole body magnetic resonance imaging to quantify regional adipose tissue and proton magnetic resonance spectroscopy was utilised to determine intrahepatocellular lipid (IHCL) levels. The relationships between ALT, body composition and components of the MS were explored using Pearson's bivariate correlation.RESULTS: The analyses revealed that elevated ALT was most strongly associated with BMI, waist circumference, systolic blood pressure, external fat and IHCL (r≥0.49, P≤0.03). On the other hand, although a positive correlation was apparent, elevated ALT demonstrated a lesser association with biochemical markers of the MS; triglycerides, fasting glucose and HDL: Cholesterol (r≤0.43, P≥0.06) and internal fat (r≤0.43, P≥0.06).CONCLUSION: Our findings indicate elevated ALT was robustly associated with increased external fat and central obesity, suggesting that ALT may have some bearing on regional fat deposition. Moreover, we have shown that raised ALT is positively correlated with several characteristics of the MS in PCOS. This data supports the notion that liver fat accumulation is important in the pathogenesis of the MS. Measurement of ALT activity should be monitored in future MS prediction algorithms in PCOS patients. OBJECTIVE: The metabolic syndrome (MS), a classical predictor of type II diabetes, is commonly present in Polycystic Ovarian Syndrome (PCOS) patients. Recent research has also shown that PCOS patients exhibit raised serum levels of Alanine Aminotransferase (ALT). Several recent studies add to the concept of ALT as a predictor of type II diabetes and the MS is ubiquitous in diabetics. The aim of this study was to investigate if ALT predicts components of the MS in PCOS patients. DESIGN: Prospective. MATERIALS AND METHODS: Twenty PCOS patients with a mean age of 26.05 ± 4.77 yrs and body mass index (BMI) of 31.23 ± 7.88 kg/m2 were recruited. Following collection of anthropometric data, all participants underwent a fasting blood sample to quantify fasting glucose, lipids and ALT. Thirteen patients underwent whole body magnetic resonance imaging to quantify regional adipose tissue and proton magnetic resonance spectroscopy was utilised to determine intrahepatocellular lipid (IHCL) levels. The relationships between ALT, body composition and components of the MS were explored using Pearson's bivariate correlation. RESULTS: The analyses revealed that elevated ALT was most strongly associated with BMI, waist circumference, systolic blood pressure, external fat and IHCL (r≥0.49, P≤0.03). On the other hand, although a positive correlation was apparent, elevated ALT demonstrated a lesser association with biochemical markers of the MS; triglycerides, fasting glucose and HDL: Cholesterol (r≤0.43, P≥0.06) and internal fat (r≤0.43, P≥0.06). CONCLUSION: Our findings indicate elevated ALT was robustly associated with increased external fat and central obesity, suggesting that ALT may have some bearing on regional fat deposition. Moreover, we have shown that raised ALT is positively correlated with several characteristics of the MS in PCOS. This data supports the notion that liver fat accumulation is important in the pathogenesis of the MS. Measurement of ALT activity should be monitored in future MS prediction algorithms in PCOS patients.