title: Factors associated with elevated serum alanine aminotransferase in patients with type 1 diabetes mellitus.
abstract: OBJECTIVE
  Metabolic syndrome and type 2 diabetes are associated with insulin resistance and hepatic steatosis, which are common causes of alanine aminotransferase (ALT) elevation. This study aims to identify variables associated with altered ALT in type 1 diabetic (DM1) subjects.
  
  
  METHODS
  A cross-sectional study conducted in the outpatient endocrinology clinic of a university hospital. Patients with DM1 were seen between December 2012 and September 2013; clinical variables were collected from medical records.
  
  
  RESULTS
  Fifty-six patients were included aged 27 ± 10.1 years; 60.7% were men. The study subjects exhibited an average ALT of 36.7 ± 10.3 U/L (median = 35 U/L) and their average Body Mass Index (BMI) was 23.8 ± 3.8 kg/m2. When comparing individuals with elevated ALT > 35 U/L (N. = 27) with those ALT ≤ 35 U/L (N. = 29), we found that individuals with ALT values > 35 U/L showed a higher proportion of men (77.8% vs. 44.8%, P = 0.012) and a higher mean age (30.2 ± 12.3 vs. 24.6 ± 6.9 years, P = 0.046). When new ALT reference values were applied (19 U/L for women and 30 U/L for men), five individuals had normal ALT values. Individuals with elevated ALT had higher BMI (24.3 vs. 20.9; P = 0.036), fasting glucose (194.8 ± 101.2 vs. 123.6 ± 42.0 mg/dL; P = 0.013) and higher HbA1c (9.9 ± 2.8 vs. 7.8 ± 0.7%; P < 0.001) levels. In Pearson correlation analysis, ALT values ​correlated with HbA1c (r = 0.285; P = 0.033).
  
  
  CONCLUSIONS
  In patients with DM1, elevated ALT values ​​are associated with BMI, fasting glucose and HbA1c.
authors.affiliation: Federal University of Santa Catarina (UFSC), Florianópolis, Santa Catarina, Brazil - janaina.narciso@uol.com.br.
authors.forename: S A
authors.initials: SA
authors.lastname: Hatanaka
authors.forename: N O
authors.initials: NO
authors.lastname: Silva
authors.forename: B S
authors.initials: BS
authors.lastname: Colombo
authors.forename: C G
authors.initials: CG
authors.lastname: Correa
authors.forename: B P
authors.initials: BP
authors.lastname: Alcaire
authors.forename: M H
authors.initials: MH
authors.lastname: Coral
authors.forename: L L
authors.initials: LL
authors.lastname: Schiavon
authors.forename: J L
authors.initials: JL
authors.lastname: Narciso-Schiavon
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood*; D001786:Blood Glucose; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood*; D005215:Fasting; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D008297:Male
chemical_list: D000410:Alanine Transaminase; D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human