Xu Jing-Yuan, Yang Long-Bao, Han Zhi-Yi, Wang Kai, Yin Zhen-Hua, Wu Ting, Shao Yong, Lu Xiao-Lan
Department of Gastroenterology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China.
Department of Gastroenterology, Shanghai Pudong Hospital of Fudan University, Shanghai 201399, China.
Oncotarget. 2021 Jul 6;12(14):1398-1405. doi: 10.18632/oncotarget.28009.
BACKGROUND/PURPOSE: Recent study suggested that type 2 diabetes (T2DM) attributed to body mass index (BMI) could be influenced by liver aminotransferase. We aim to ascertain the cut-off point of BMI associated with T2DM and the influence of both elevated aminotransferase (AST) and alanine aminotransferase (ALT).
In our retrospective cohort study, T2DM was diagnosed when FBS ≥ 7.0 mmol/L, BMI of participants with baseline fasting (FBS) < 7.0 mmol/L was divided by percentiles and by aminotransferanse (ALT and AST ≥ 20 U/L, ALT or AST < 20 U/L). Hazard ratios and the turning point of BMI of high T2DM risk was estimated in totality and different aminotransferanse groups.
During an average follow-up time of 3.71 years of 33346 participants, 1486 developed T2DM, and the average baseline BMI of participants who developed T2DM was 26.22 kg/m. Cumulative incidence of T2DM was more than 5% when ALT and AST ≥ 20U/L, age over 44, male sex or BMI over 25.39 kg/m; The risk of T2DM incidence increased as the BMI grow. The turning point of BMI at high risk of T2DM was 25.0 kg/m in totality, 25.1 kg/m when ALT or AST < 20 U/L and 26.1 kg/m when ALT and AST ≥ 20U/L.
BMI of 25.0 kg/m was the cutoff point for T2DM development, and there is greater association between BMI and T2DM when ALT or AST < 20 U/L.
背景/目的:近期研究表明,归因于体重指数(BMI)的2型糖尿病(T2DM)可能受肝脏转氨酶影响。我们旨在确定与T2DM相关的BMI切点以及转氨酶(AST)和丙氨酸转氨酶(ALT)升高的影响。
在我们的回顾性队列研究中,当空腹血糖(FBS)≥7.0 mmol/L时诊断为T2DM,基线空腹血糖(FBS)<7.0 mmol/L的参与者的BMI按百分位数以及转氨酶(ALT和AST≥20 U/L、ALT或AST<20 U/L)进行划分。在总体人群和不同转氨酶组中估计高T2DM风险的危险比和BMI转折点。
在33346名参与者平均3.71年的随访期内,1486人患T2DM,患T2DM参与者的平均基线BMI为26.22 kg/m²。当ALT和AST≥20U/L、年龄超过44岁、男性或BMI超过25.39 kg/m²时,T2DM的累积发病率超过5%;T2DM发病风险随BMI增加而升高。总体上T2DM高风险的BMI转折点为25.0 kg/m²,ALT或AST<20 U/L时为25.1 kg/m²,ALT和AST≥20U/L时为26.1 kg/m²。
25.0 kg/m²的BMI是T2DM发生的切点,当ALT或AST<20 U/L时,BMI与T2DM之间的关联更强。