Alanine aminotransferase to high- density lipoprotein cholesterol ratio is positively correlated with the occurrence of diabetes in the Chinese population: a population-based cohort study

Abstract

ObjectiveBoth alanine aminotransferase (ALT) and high-density lipoprotein cholesterol (HDL-C) are closely related to glucose homeostasis in the body, and the main objective of this study was to investigate the association between ALT to HDL-C ratio (ALT/HDL-C ratio) and the risk of diabetes in a Chinese population.MethodsThe current study included 116,251 participants who underwent a healthy physical examination, and the study endpoint was defined as a diagnosis of new-onset diabetes. Multivariate Cox regression models and receiver operator characteristic curves were used to assess the association of the ALT/HDL-C ratio with diabetes onset.ResultsDuring the average observation period of 3.10 years, a total of 2,674 (2.3%) participants were diagnosed with new-onset diabetes, including 1,883 (1.62%) males and 791 (0.68%) females. After fully adjusting for confounding factors, we found a significant positive association between the ALT/HDL-C ratio and the risk of diabetes [Hazard ratios 1.06, 95% confidence intervals: 1.05, 1.06], and this association was significantly higher in males, obese individuals [body mass index ≥ 28 kg/m2] and individuals aged < 60 years (All P interaction < 0.05). In addition, the ALT/HDL-C ratio was significantly better than its components ALT and HDL-C in predicting diabetes in the Chinese population.ConclusionThere was a positive relationship between ALT/HDL-C ratio and diabetes risk in the Chinese population, and this relationship was significantly stronger in males, obese individuals, and individuals younger than 60 years old.

The association of ALT to HDL-C ratio with type 2 diabetes in 50–74 years old adults: a population-based study

“…This conclusion was obtained in a multiple regression model and after controlling of confounding variables such as waist circumference, hypertension and sex. To the best of our knowledge, this report is the first study in Iran that measured the association between this ratio and DM, furthermore, it is one of the few reports worldwide investigating this issue, with results similar to two other existing articles 20 , 21 . Our findings indicate that individuals with DM tend to have higher levels of ALT and lower levels of HDL-C. Other studies have also demonstrated that individuals with DM have higher ALT levels compared to those without DM, and that elevated ALT levels are directly linked to the development of DM 11 – 13 , 24 – 26 .…”

“…Recently, a longitudinal study with a follow-up period of 3.1 years revealed that the ratio of ALT to HDL was positively associated with the prediction of diabetes. This ratio was found to be superior to considering ALT and HDL-C separately 21 . The ALT to HDL-C ratio has been introduced as a combined marker for early diagnosis of DM.…”

“…Simple and multiple logistic regression was used to investigate the association between DM and ALT/HDL-C. The ALT to HDL-C ratio was dichotomized using the cutoff, provided by He et al 21 . The association of this new variable with DM was assessed in another multiple logistic regression model.…”

The ratio of alanine aminotransferase to high-density lipoprotein cholesterol is positively correlated with the insulin resistance in American adults: a population-based cohort study

“…Moreover, an elevation in HDL-C is widely recognized as a protective factor against IR ( 28 ). Furthermore, recent studies have proposed that the combination of HDL-C and ALT may serve as a more sensitive and novel biomarker for assessing inflammatory and metabolic disorders ( 14 , 15 ).…”

“…Recently, Cao et al conducted a study investigating the combination of HDL-C and ALT, and the findings suggest that the ALT/HDL-C ratio serves as a valuable novel predictor for the risk in the development of diabetes in Japanese ( 14 ). He et al conducted a study on a total of 116,251 Chinese people and found a positive correlation between the risk in the development of diabetes and the ALT/HDL-C ( 15 ). However, the existence of an association between IR risk and ALT/HDL-C remains unclear.…”