Alanine aminotransferase/aspartate aminotransferase ratio is the best surrogate marker for insulin resistance in non-obese Japanese adults

Kawamoto, Ryuichi; Kohara, Katsuhiko; Kusunoki, Tomo; Tabara, Yasuharu; Abe, Masanori; Miki, Tetsuro

doi:10.1186/1475-2840-11-117

Cited by 70 publications

(75 citation statements)

References 36 publications

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“…This result suggested that insulin resistance might be involved in the process of arterial lesions [23]. A Japanese study even recommended using ALT/AST ratio to reflect the extent of insulin resistance [24]. Therefore, FGF21, a mainly liver-derived cytokine, was found to be associated with the occurrence of CAD in this study, which might be explained, concerning the mechanism, by the involvement of insulin resistance.…”

Section: Discussionmentioning

confidence: 56%

Additive relationship between serum fibroblast growth factor 21 level and coronary artery disease

Shen

Zhou

et al. 2013

Cardiovasc Diabetol

129

102

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BackgroundExpression and activity of the fibroblast growth factor (FGF) 21 hormone-like protein are associated with development of several metabolic disorders. This study was designed to investigate whether serum FGF21 level was also associated with the metabolic syndrome-related cardiovascular disease, atherosclerosis, and its clinical features in a Chinese cohort.MethodsTwo-hundred-and-fifty-three subjects visiting the Cardiology Department (Sixth People's Hospital affiliated to Shanghai JiaoTong University) were examined by coronary arteriography (to diagnose coronary artery disease (CAD)) and hepatic ultrasonography (to diagnose non-alcoholic fatty liver disease (NAFLD)). Serum FGF21 level was measured by enzyme-linked immunosorbent assay and analyzed for correlation to subject and clinical characteristics. The independent factors of CAD were determined by multivariate logistic regression analysis.ResultsSubjects with NAFLD showed significantly higher serum FGF21 than those without NAFLD (388.0 pg/mL (253.0-655.4) vs. 273.3 pg/mL (164.9-383.7), P < 0.01). Subjects with CAD showed significantly higher serum FGF21, regardless of NAFLD diagnosis (P < 0.05). Serum FGF21 level significantly elevated with the increasing number of metabolic disorders (P for trend < 0.01). After adjustment of age, sex, and BMI, FGF21 was positively correlated with total cholesterol (P < 0.05) and triglyceride (P < 0.01). FGF21 was identified as an independent factor of CAD (odds ratio = 2.984, 95% confidence interval: 1.014-8.786, P < 0.05).ConclusionsIncreased level of serum FGF21 is associated with NAFLD, metabolic disorders and CAD.

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Section: Discussionmentioning

confidence: 56%

Additive relationship between serum fibroblast growth factor 21 level and coronary artery disease

Shen

Zhou

et al. 2013

Cardiovasc Diabetol

129

102

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“…De-ritis ratio which is used as surrogate marker for identifying non-alcoholic fatty liver disease was increased among T2DM with CAD when compared with T2DM without CAD [16]. Some other studies have also reported that NALFD and insulin resistance was an independent risk for CAD.…”

Section: Resultsmentioning

confidence: 86%

Association between Hepato-Biliary Status and HbA1C in Type 2 Diabetes Mellitus with Coronary Artery Disease (CAD)

Ramesh¹,

AdhishwarKumaran²,

KuzhandaiVelu³

et al. 2015

JDM

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Bilirubin has both antioxidant activity and cardio-protective potential. Decreased levels are associated with predicting CAD. Recent studies showed that bilirubin has inverse correlation with glycemic status. So in this we evaluated the role of Hepato-biliary function as a marker of predictor CAD in patient with T2DM. Total 100 subjects included 50 T2DM patients with CAD and 50 T2DM without CAD. All the subject venous blood was collected after overnight fasting for biochemical analysis. After the statistical analysis, the results showed significant difference between two groups as follows total bilirubin (0.32 ± 0.15; 0.90 ± 032; p = 0.000), direct bilirubin, indirect bilirubibn, Total Protein, Albumin, ALT, AST, HbA1c. Our finding implies that decreased serum bilirubin increases the risk of CAD in patients with T2DM and it shows inverse correlation between HbA1c and bilirubin.

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“…8 More recently, the ALT/AST ratio has been shown to be a better surrogate marker than ALT for predicting insulin resistance in a Japanese cohort. 21 In prior epidemiologic studies, elevation in ALT has most frequently been utilized as a surrogate marker for NAFLD. 7, 22 It is well established that NAFLD may be present in those with aminotransferase levels within the normal range.…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of the Framingham Steatosis Index to Identify Persons With Hepatic Steatosis

Long

Pedley

Colantonio

et al. 2016

Clinical Gastroenterology and Hepatology

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Background & Aims Serum levels of aminotransferases are used as markers of non-alcoholic fatty liver disease in epidemiology research. However, it is not clear whether they can be to identify patients with fatty liver. We investigated the accuracy of serum levels of aminotransferases in detection of hepatic steatosis. Additionally, we derived a Framingham steatosis index (FSI), and tested its ability to identify patients with hepatic steatosis in an independent cohort. Methods We performed a cross-sectional study of 1181 members of the Framingham Third Generation Cohort (46.1% women, mean age 50.3±6.7 years). People with hepatic steatosis were identified by computed tomography, performed from 2008 through 2011. We compared the abilities of levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST), and the ratio of ALT:AST, to identify people with hepatic steatosis using c-statistic analyses. We performed a stepwise regression procedure to identify demographic and clinical factors that correlated with hepatic steatosis; we used these, along with biochemical factors associated with steatosis, to develop the FSI. We validated the FSI using data from the third National Health and Nutrition Examination Survey (NHANES III). Results The prevalence of hepatic steatosis in the Framingham Third Generation Cohort was 26.8%. The ratio of ALT:AST identified people with hepatic steatosis with the highest c-statistic value (0.728); the value for only ALT was 0.706 and the value for only AST was 0.589. We derived the FSI based on patient age, sex, body mass index, levels of triglycerides, hypertension, diabetes, and ratio of ALT:AST. The FSI identified patients with hepatic steatosis with a c-statistic value of 0.845. When it was applied to the NHANES III cohort, the FSI identified patients with steatosis with a c-statistic value of 0.760 and was well calibrated. Conclusions In an analysis of the Framingham Third Generation Cohort, we found the ratio of ALT:AST to identify people with hepatic steatosis more accurately than either ALT or AST alone. We used data from this cohort to develop and validate the FSI, which identifies patients with steatosis with a c-statistic value of about 0.8.

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Alanine aminotransferase/aspartate aminotransferase ratio is the best surrogate marker for insulin resistance in non-obese Japanese adults

Cited by 70 publications

References 36 publications

Additive relationship between serum fibroblast growth factor 21 level and coronary artery disease

Additive relationship between serum fibroblast growth factor 21 level and coronary artery disease

Association between Hepato-Biliary Status and HbA1C in Type 2 Diabetes Mellitus with Coronary Artery Disease (CAD)

Development and Validation of the Framingham Steatosis Index to Identify Persons With Hepatic Steatosis

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