Association of liver enzymes with incident type 2 diabetes: A nested case control study in an Iranian population.
BACKGROUND
To investigate the association of Aspartate aminotransferase (AST), Alanin aminotranferase (ALT) and Gamma glutamyl transferase (GGT) with incident type 2 diabetes.


METHODS
In a nested case-control study, AST, ALT, GGT as well as classic diabetes risk factors, insulin and C-reactive protein (CRP) were measured in 133 non-diabetic subjects at baseline of which 68 were cases and 65 were controls. Incident diabetes was defined by the WHO 1999 criteria. Conditional logistic regression was used to calculate the odds ratio (OR) of incident diabetes associated with different hepatic markers. We used factor analysis for clustering of classic diabetes risk factors.


RESULTS
In Univariate analysis both ALT and GGT were associated with diabetes with ORs of 3.07(1.21-7.79) and 2.91(1.29-6.53) respectively. After adjustment for CRP and insulin, ALT and GGT were still predictive of incident diabetes. When the model was further adjusted for anthropometric, blood pressure and metabolic factors, only ALT was independently associated with diabetes [OR = 3.18 (1.02-9.86)]. No difference was found between the area under the receiver operating characteristic curves of the models with and without ALT (0.820 and 0.802 respectively, P = 0.4)


CONCLUSIONS
ALT is associated with incident type 2 diabetes independent of classic risk factors. However, its addition to the classic risk factors does not improve the prediction of diabetes.
Tohidi
Maryam
M
Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University (M,C), Tehran, Iran. tohidi@erc.ac.ir
Harati
Hadi
H
Hadaegh
Farzad
F
Mehrabi
Yadolladh
Y
Azizi
Fereidoun
F