impact of increasing alanine aminotransferase levels within normal range on incident diabetes

impact of increasing alanine aminotransferase levels within normal range on incident diabetes

;Chong-Shan Wang;Ting-Tsung Chang;Wei-Jen Yao;Shan-Tair Wang;Pesus Chou
Bioorganic & medicinal chemistry letters 2012 Vol. 111 pp. 201-208
188
wang2012journalimpact

Abstract

Abnormal alanine aminotransferase level (ALT) levels might be associated with type 2 diabetes, but whether higher ALT levels within the normal range predict the risk is unknown. Methods: We followed a community-based cohort of 3446 individuals who were ≥35 years old without diabetes and hepatitis B or C in southern Taiwan for 8 years (1997–2004) to study the risk for type 2 diabetes with different normal ALT levels. Results: Among the 337 incident diabetes cases, 16.0% were from those with ALT levels <10 IU/L, 44.5% with ALT levels 10–19 IU/L, 30.0% with ALT levels 20–39 IU/L, and only 9.5% with ALT levels ≥40 IU/L. A cumulative hazard function test showed that the higher the ALT levels, the greater the cumulative incidence rate of diabetes (p < 0.001, log-rank test). A multiple Cox proportional hazards analysis showed that increasing age, lower educational levels, higher body mass index levels (≥25 vs. <25), and higher ALT levels (vs. the reference group, ALT <10 IU/L), from hazard ratio (HR) = 1.8, for ALT = 10–19, HR = 3.7 for ALT = 20–39, to HR = 4.5 for ALT ≥40, were significant factors for developing diabetes (p < 0.001). The hazard ratios of higher ALT levels in the participants without alcohol consumption were similar to or higher than those in the total cohort. Conclusion: Higher ALT levels, even within the normal range, are strong predictors of type 2 diabetes independently of body mass index levels with a dose–response relationship.

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10.1016/j.jfma.2011.04.004
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