high liver enzyme concentrations are associated with higher glycemia, but not with glycemic variability, in individuals without diabetes mellitus

high liver enzyme concentrations are associated with higher glycemia, but not with glycemic variability, in individuals without diabetes mellitus

;Raymond Noordam;Debbie Vermond;Debbie Vermond;Hermijntje Drenth;Hermijntje Drenth;Carolien A. Wijman;Abimbola A. Akintola;Sabrina van der Kroef;Steffy W. M. Jansen;Neline C. Huurman;Bianca A. M. Schutte;Marian Beekman;P. Eline Slagboom;Simon P. Mooijaart;Simon P. Mooijaart;Diana van Heemst
aip advances 2017 Vol. 8 pp. -
148
noordam2017frontiershigh

Abstract

BackgroundElevated concentrations of liver enzymes have been associated with an increased risk of developing type 2 diabetes mellitus. However, it remains unclear to which specific aspects of diurnal glucose metabolism these associate most. We aimed to investigate the associations between liver enzyme concentrations and 24 h-glucose trajectories in individuals without diabetes mellitus from three independent cohorts.MethodsThis cross-sectional study included 436 participants without diabetes mellitus from the Active and Healthy Aging Study, the Switchbox Study, and the Growing Old Together Study. Fasting blood samples were drawn to measure gamma-glutamyltransferase (GGT), alanine transaminase, and aspartate transaminase. Measures of glycemia (e.g., nocturnal and diurnal mean glucose levels) and glycemic variability (e.g., mean amplitude of glucose excursions) were derived from continuous glucose monitoring. Analyses were performed separately for the three cohorts; derived estimates were additionally meta-analyzed.ResultsAfter meta-analyses of the three cohorts, elevated liver enzyme concentrations, and specifically elevated GGT concentrations, were associated with higher glycemia. More specific, participants in the highest GGT tertile (GGT ≥37.9 U/L) had a 0.39 mmol/L (95% confidence interval: 0.23, 0.56) higher mean nocturnal glucose (3:00 to 6:00 a.m.) and a 0.23 mmol/L (0.10, 0.36) higher diurnal glucose (6:00 to 0:00 a.m.) than participants in the lowest GGT tertile (GGT <21.23 U/L). However, elevated liver enzyme concentrations were not associated with a higher glycemic variability.ConclusionThough elevated liver enzyme concentrations did not associate with higher glycemic variability in participants without diabetes mellitus, specifically, elevated GGT concentrations associated with higher glycemia.

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