Elevated alanine aminotransferase is associated with metabolic syndrome but not consistently associated with impaired fasting glucose or type 2 diabetes mellitus

Yueh, Chen-Yu; Chen, Jung-Hsiang; Lee, Li-Wen; Lu, Cheng‐Wei; Parekh, Bhavin K; Chi, Ching‐Chi

doi:10.1016/j.diabres.2011.05.038

Cited by 5 publications

(5 citation statements)

References 34 publications

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“…Metabolic syndrome (MetS) (Tsai et al, 2011;Yueh et al, 2011) was present if at least three of the following five criteria were met: (1) central obesity-waist circumference 490 cm based on Taiwanese criteria (Chu, 2005);…”

Section: Metabolic Syndromementioning

confidence: 99%

Long-term day-and-night rotating shift work poses a barrier to the normalization of alanine transaminase

Lin

Hsieh

Chen

2013

Chronobiology International

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To evaluate the impact of day-and-night rotating shift work (RSW) on liver health, we performed a retrospective analysis of the association between long-term RSW exposure and the normalization of plasma alanine transaminase (ALT) levels over a five-year period. The data from physical examinations, blood tests, abdominal sonographic examinations, personal histories, and occupational records were collected from a cohort of workers in a semiconductor manufacturing company. The sample population was divided into three subgroups for analysis, according to self-reported shift work status over the five-year interval: persistent daytime workers, workers exposed intermittently to RSW (i-RSW), and workers exposed persistently to RSW (p-RSW). Records were analyzed for 1196 male workers with an initial mean age of 32.5 years (SD 6.0 years), of whom 821 (68.7%) were identified as rotating shift workers, including 374 i-RSW (31.3%) and 447 p-RSW workers (37.4%). At the beginning of the follow-up, 275 were found to have elevated ALT (e-ALT): 25.1% daytime workers, 23.0% i-RSW workers, and 21.3% p-RSW workers (p = 0.098). Of those with e-ALT at the beginning, 101 workers showed normalized serum ALT levels at the end of five-year follow-up: 40 (10.7%) of 375 daytime workers, 32 (8.6%) of 374 i-RSW workers, and 29 (6.5%) of 447 p-RSW workers (p = 0.016). Compared with the workers having persistent e-ALT at the end of follow-up, the workers normalized serum ALT levels had significantly lesser exposures to RSW during follow-up. By performing multivariate logistic regression analyses, and comparing with the persistent daytime co-workers, after controlling for confounding variables (age, occupational factors, educational levels, lifestyle factors, metabolic syndrome, hepatovirus infection, and fatty liver), analysis indicated that the workers exposed to p-RSW were 46% less likely (OR, 0.54; 95% CI, 0.30-0.95; p = 0.03) to attain normal ALT levels within a five-year interval. These observations demonstrate that persistent day-and-night RSW pose a vigorous obstacle to the normalization of e-ALT among workers with preexisting abnormal liver function. We suggest that workers and managers approach with caution the consideration of assigning or accepting long-term day-and-night RSW when an employee health screening shows evidence of abnormal liver function.

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Section: Metabolic Syndromementioning

confidence: 99%

Long-term day-and-night rotating shift work poses a barrier to the normalization of alanine transaminase

Lin

Hsieh

Chen

2013

Chronobiology International

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“…In this study and our previous observation, elevated ALT was not consistently associated with diabetes mellitus [19]. This may give explanation to the controversy among different studies about the association between ALT values and diabetes mellitus [12-15, 17-19, 30].…”

Section: Demographic Of People Studiedmentioning

confidence: 36%

“…For example, Perry et al and Doi et al reported a positive association between GGT levels and risk of type 2 diabetes mellitus, which was opposed by Vozarova et al's conclusion "higher ALT but not aspartate aminotransferase (AST) or GGT, predicted diabetes" [12,16,17]. Our previous study also found that elevated ALT was associated with metabolic syndrome and abdominal obesity but not independently associated with impaired fasting glucose or type 2 diabetes mellitus [19]. Given that elevated ALT may sometimes reflect an underlying insulin resistance, and is associated with whole body adiposity, it is worth verifying whether elevated ALT could offer synergistic effect on metabolic syndrome characteristic features for predicting new-onset diabetes mellitus in a larger population.…”

Section: Alt Measurementmentioning

confidence: 68%

“…1, with further adjustment for BMI, high blood pressure, high serum triglyceride, low HDL-C and viral hepatitis history, obese people with elevated ALT had significantly higher odds to have newly diagnosed diabetes mellitus (non-obese people with normal ALT, 1.7% as reference; ALT ≤ 40 U/L: 4.7%, OR 1.73, 95% CI 1.08-2.77, P 0.023; ALT 41-80 U/L: 6.8%, OR 2.06, 95% CI 1.20-3.55, P 0.009; our previous observation [19], metabolic syndrome and elevated ALT seemed associated with diabetes mellitus (details not shown here) and newly diagnosed diabetes mellitus (people with metabolic syndrome vs. non-metabolic syndrome, OR 10.56, 95% CI 7.23-15.43; people with various elevated ALT levels vs. normal ALT levels, ORs 2.06-6.00). However, with further adjustment for metabolic syndrome and viral hepatitis history, elevated ALT per se was not consistently associ- The data are shown in number of people followed by percentage.…”

Section: Demographic Of People Studiedmentioning

confidence: 99%

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Abdominal obesity validates the association between elevated alanine aminotransferase and newly diagnosed diabetes mellitus

et al. 2014

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“…The only previous study using CGM-derived measures of glycemia observed associations between ALT and mean nocturnal and diurnal glucose concentrations ( 13 ). Nevertheless, a study conducted in participants of Taiwanese ancestry observed an association between ALT and metabolic syndrome, but not with elevated fasting glucose concentrations and T2DM ( 29 ). Together with our results, this supports that the investigated liver enzymes reflect different aspects of liver function.…”

Section: Discussionmentioning

confidence: 99%

High Liver Enzyme Concentrations are Associated with Higher Glycemia, but not with Glycemic Variability, in Individuals without Diabetes Mellitus

et al. 2017

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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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Elevated alanine aminotransferase is associated with metabolic syndrome but not consistently associated with impaired fasting glucose or type 2 diabetes mellitus

Cited by 5 publications

References 34 publications

Long-term day-and-night rotating shift work poses a barrier to the normalization of alanine transaminase

Long-term day-and-night rotating shift work poses a barrier to the normalization of alanine transaminase

Abdominal obesity validates the association between elevated alanine aminotransferase and newly diagnosed diabetes mellitus

High Liver Enzyme Concentrations are Associated with Higher Glycemia, but not with Glycemic Variability, in Individuals without Diabetes Mellitus

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