Niu Hua, Zhou Yinghua
Department of Ultrasound Medicine, Xidian Group Hospital, Xi'an, 710077, People's Republic of China.
Department of Ultrasound Medicine, Xi'an Gaoxin Hospital, Xi'an, 710075, People's Republic of China.
Int J Gen Med. 2021 Nov 18;14:8373-8382. doi: 10.2147/IJGM.S341790. eCollection 2021.
The aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio has been demonstrated to be associated with insulin resistance and metabolic syndrome. However, few studies have directly explored the association between the AST/ALT ratio and the incidence of type 2 diabetes mellitus (T2DM). As such, the present study aimed to investigate the relationship between the AST/ALT ratio and incident T2DM during follow-up in a population-based cohort.
This retrospective cohort analysis included 15,464 Japanese males and females without DM at baseline between 2004 and 2015. The association between AST/ALT ratio and T2DM was retrospectively examined using the Cox proportional hazard model after adjusting for multiple potential confounders.
After follow-up, 373 (2.41%) patients developed T2DM. A nonlinear relationship between the AST/ALT ratio and T2DM was observed after adjusting for potential confounders. The risk for developing T2DM decreased with AST/ALT ratio up to a threshold of 0.93 (adjusted hazard ratio [HR] 0.14 [95% confidence interval (CI) = 0.02-0.90; = 0.0385]). An AST/ALT ratio >0.93 was not associated with the risk for developing T2DM (adjusted HR = 0.67, 95% CI = 0.17-2.65; = 0.5718).
The AST/ALT ratio was associated with a lower incidence of T2DM in a nonlinear pattern. The threshold AST/ALT ratio for developing T2DM was 0.93. AST/ALT levels were inversely correlated with the occurrence of T2DM when AST/ALT ratio ≤0.93.
天冬氨酸转氨酶（AST）与丙氨酸转氨酶（ALT）的比值已被证明与胰岛素抵抗和代谢综合征有关。然而，很少有研究直接探讨AST/ALT比值与2型糖尿病（T2DM）发病率之间的关联。因此，本研究旨在调查在一个基于人群的队列随访期间AST/ALT比值与新发T2DM之间的关系。
这项回顾性队列分析纳入了在2004年至2015年期间基线时无糖尿病的15464名日本男性和女性。在调整多个潜在混杂因素后，使用Cox比例风险模型回顾性检验AST/ALT比值与T2DM之间的关联。
随访后，373名（2.41%）患者发生了T2DM。在调整潜在混杂因素后，观察到AST/ALT比值与T2DM之间存在非线性关系。随着AST/ALT比值升高至0.93的阈值，发生T2DM的风险降低（调整后风险比[HR]为0.14[95%置信区间（CI）=0.02-0.90；P=0.0385]）。AST/ALT比值>0.93与发生T2DM的风险无关（调整后HR=0.67，95%CI=0.17-2.65；P=0.5718）。
AST/ALT比值与T2DM的较低发病率呈非线性相关。发生T2DM的AST/ALT比值阈值为0.93。当AST/ALT比值≤0.93时，AST/ALT水平与T2DM的发生呈负相关。
