title: Liver enzymes and incident diabetes: findings from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study.
abstract: OBJECTIVE
  We sought to examine the association between plasma concentrations of liver enzymes gamma-glutamyltransferase (GGT) and alanine transaminase (ALT) and incident diabetes, prospectively.
  
  
  METHODS
  We conducted a case-cohort analysis of data from participants mainly aged 35-65 years in the European Prospective Investigation into Cancer and Nutrition-Potsdam Study. The analytic sample included 787 participants with incident diabetes and 2,224 participants without diabetes.
  
  
  RESULTS
  Concentrations of GGT and ALT were significantly associated with incident diabetes after extensive adjustment. Compared with participants in the lowest quintile of GGT, the adjusted hazard ratios for increasing quintiles were 1.13 (95% CI 0.66-1.93), 1.67 (1.01-2.77), 2.77 (1.71-4.49), and 2.67 (1.63-4.37), respectively (P for linear trend <0.001). Compared with participants in the lowest quintile of ALT, the adjusted hazard ratios for incident diabetes were 0.93 (0.56-1.53) for quintile 2, 1.28 (0.83-1.96) for quintile 3, 1.35 (0.88-2.07) for quintile 4, and 1.93 (1.27-2.92) for quintile 5 (P for linear trend = 0.002). The magnitude of the associations were higher among men than women for GGT (P = 0.004) but did not differ significantly between men and women for ALT (P = 0.307).
  
  
  CONCLUSIONS
  Concentrations of GGT and ALT were significant predictors of incident diabetes in this study, even at concentrations still considered to be within the normal range.
authors.affiliation: Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Earl S
authors.initials: ES
authors.lastname: Ford
authors.forename: Matthias B
authors.initials: MB
authors.lastname: Schulze
authors.forename: Manuela M
authors.initials: MM
authors.lastname: Bergmann
authors.forename: Claus
authors.initials: C
authors.lastname: Thamer
authors.forename: Hans-Georg
authors.initials: HG
authors.lastname: Joost
authors.forename: Heiner
authors.initials: H
authors.lastname: Boeing
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D003920:Diabetes Mellitus / Q000097:blood / Q000201:enzymology* / Q000453:epidemiology*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008019:Life Style; D008099:Liver / Q000201:enzymology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011795:Surveys and Questionnaires; D005723:gamma-Glutamyltransferase / Q000097:blood*
chemical_list: D015415:Biomarkers; D005723:gamma-Glutamyltransferase; D000410:Alanine Transaminase