Zhongguo quanke yixue (Oct 2023)
Association of Alanine Transaminase and Aspartate Aminotransferase/Alanine Transaminase Ratio with Type 2 Diabetes and Metabolic Syndrome in the Elderly
Abstract
Background Serum alanine transaminase (ALT) and aspartate aminotransferase (AST) are common liver enzymes, but there are few studies on the correlation of these enzymes with the prevalence of type 2 diabetes mellitus (T2DM) and metabolic syndrome (MS) . Objective To explore the association of serum ALT and AST/ALT ratio with T2DM and MS in older physical examinees in the community. Methods From January to December, 2018, 30 060 elderly people (≥65 years) who underwent free physical examination in 19 community health centers of 6 districts in Wuhan were chosen as the subjects. Their demographic data, life style, previous medical history, and results of physical examination and biochemical test were collected. Subjects were divided into quartile groups of ALT〔Q1 (ALT≤11 U/L, n=8 116), Q2 (11 U/L<ALT≤14 U/L, n=7 008), Q3 (14 U/L<ALT≤19 U/L, n=7 438), Q4 (ALT>19 U/L, n=7 498) 〕, or quartile groups of AST/ALT ratio〔q1 (AST/ALT≤1.06, n=7 386), q2 (1.06<AST/ALT≤1.31, n=7 698), q3 (1.31<AST/ALT≤1.62, n=7 529), q4 (AST/ALT>1.62, n=7 447) 〕. Cochran χ2 test was used to compare the prevalence trend of T2DM, MS, abdominal obesity, hypertension, elevated triglycerides (TG) and lowered high-density lipoprotein cholesterol (HDL-C) with the change of ALT level and AST/ALT ratio. Multivariate Logistic regression analysis was used to explore the correlation of prevalence of T2DM and MS with ALT level and AST/ALT ratio. Results The age of 30 060 subjects (13 381 men and 16 679 women) was 65-99 years old, and the average age was (71.7±5.6) years old. The prevalence of T2DM and MS was 18.76% (5 488/30 060) and 29.73% (8 938/30 060), respectively. The regular exercise rate, BMI, waist circumference, systolic pressure, diastolic pressure, ALT, TG and fasting plasma glucose (FPG) were significantly higher and smoking rate, drinking rate, AST, AST/ALT ratio, total cholesterol (TC), HDL-C, low-density lipoprotein cholesterol (LDL-C) were significantly lower in T2DM subjects compared to non-T2DM subjects (P<0.01). MS subjects had significantly higher regular exercise rate, BMI, waist circumference, systolic pressure, diastolic pressure, ALT, TC, TG and FPG, and significantly lower male ratio, smoking rate, drinking rate, AST/ALT ratio, HDL-C and LDL-C than non-MS subjects (P<0.01). The prevalence of T2DM, MS, abdominal obesity, hypertension, elevated TG and lowered HDL-C increased with the increase of ALT level, and decreased with the increase of AST/ALT ratio (P<0.01). Multivariate Logistic regression analysis showed that compared with group Q1, the risk of T2DM and MS in group Q2-Q4 was increased (P<0.01), and the risk of T2DM and MS in group Q2-Q4 was decreased compared with group q1 (P<0.01). The prevalence risk of T2DM and MS was increased in Q2-Q4 groups compared to Q1 group, and in contrast, the risk was decreased in q2-q4 groups when comparing to q1 group (P<0.01) . Conclusion Serum ALT have an association with the prevalence of T2DM and MS, as well as AST/ALT ratio. Either elevated ALT or lowered AST/ALT ratio may increase the risk of prevalence of T2DM and MS.
Keywords
