title: Alanine aminotransferase is associated with an adverse nocturnal blood glucose profile in individuals with normal glucose regulation.
abstract: OBJECTIVE
  Although the association between alanine aminotransferase (ALT) levels and risk of type 2 diabetes is well-studied, the effects of slightly increased ALT levels within the normal range on the temporal normal glucose profile remains poorly understood.
  
  
  METHODS
  A total of 322 Chinese subjects without impaired glucose tolerance or previous diagnoses of diabetes were recruited for study from 10 hospitals in urban areas across China. All subjects wore a continuous glucose monitoring (CGM) system for three consecutive days. The diurnal (06∶00-20∶00) and nocturnal (20∶00-06∶00) mean blood glucose (MBG) levels were calculated. Subjects were stratified by ALT quartile level and correlation analyses were performed.
  
  
  RESULTS
  The median ALT level was 17 IU/L, and subjects with ALT ≥17 IU/L had higher nocturnal MBG level than those with ALT <17 IU/L (P<0.05). Nocturnal MBG was positively correlated with ALT levels (Pearson correlation analysis: r = 0.187, P = 0.001), and the correlation remained significant after correction for the homeostatic model assessment of insulin resistance index (HOMA-IR) (r = 0.105, P = 0.041). No correlations were found between diurnal MBG and ALT, and nocturnal or diurnal MBG and aspartate aminotransferase or gamma-glutamyltransferase (all, P>0.05). Multivariate stepwise regression analysis of elevated nocturnal MBG identified increased HOMA-IR, elevated ALT levels, and decreased homeostatic model assessment of ß-cell function as independent factors (all, P<0.05).
  
  
  CONCLUSIONS
  Mildly elevated ALT levels, within the normal range, are associated with unfavorable nocturnal glucose profiles in Chinese subjects with normal glucose regulation.
authors: Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai Diabetes Institute, Shanghai Clinical Center for Diabetes, Shanghai, China.
authors: Jian
authors: J
authors: Zhou
authors: Yifei
authors: Y
authors: Mo
authors: Hong
authors: H
authors: Li
authors: Xingwu
authors: X
authors: Ran
authors: Wenying
authors: W
authors: Yang
authors: Qiang
authors: Q
authors: Li
authors: Yongde
authors: Y
authors: Peng
authors: Yanbing
authors: Y
authors: Li
authors: Xin
authors: X
authors: Gao
authors: Xiaojun
authors: X
authors: Luan
authors: Weiqing
authors: W
authors: Wang
authors: Weiping
authors: W
authors: Jia
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000378:metabolism*; D001786:Blood Glucose / Q000378:metabolism*; D002940:Circadian Rhythm / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors
chemical_list: D001786:Blood Glucose; D000410:Alanine Transaminase