Department of Rehabilitation, Shenzhen Dapeng New District Nan'ao People's Hospital, No. 6, Renmin Road, Dapeng New District, Shenzhen, 518000, Guangdong Province, China.
Department of Nephrology, Shenzhen Second People's Hospital, The First Affiliated Hospital of Shenzhen University, Shenzhen, 518000, Guangdong Province, China.
BMC Endocr Disord. 2023 May 29;23(1):124. doi: 10.1186/s12902-023-01382-7.
Low levels of high-density lipoprotein cholesterol (HDL-C) and high levels of alanine aminotransferase (ALT) are related to insulin resistance, metabolic syndrome, and diabetes mellitus (DM). However, evidence on the connection between the alanine aminotransferase to high-density lipoprotein cholesterol (ALT/HDL-C) ratio and diabetes mellitus (DM) risk was limited. The study aimed to investigate the relationship between baseline ALT/HDL-C ratio and DM among Japanese individuals.
This second analysis was based on a cohort study using open-source data. Data from 15,342 individuals who participated in the medical examination program were recorded at Murakami Memorial Hospital in Japan between 2004 and 2015. Smooth curve fitting, subgroup analysis, Cox proportional-hazards regression, and a series of sensitivity analyses were conducted to examine the relationship between ALT/HDL-C ratio and incident diabetes. The ability of the ALT/HDL-C ratio to predict diabetes was evaluated using a receiver operating characteristic curve analysis.
After controlling for confounding covariates, the ALT/HDL-C ratio was found to be positively correlated to the DM risk in Japanese adults (HR: 1.01, 95%CI: 1.00-1.02, P = 0.049). This study also found a stable relationship between ALT/HDL-C ratio and diabetes after employing a series of sensitivity analyses. Additionally, there was a non-linear association between the ALT/HDL-C ratio and incident diabetes, and the ALT/HDL-C ratio inflection point was 30.12. When the ALT/HDL-C ratio was below 30.12, the present study discovered a significant positive association between the ALT/HDL-C ratio and incident diabetes (HR: 1.04, 95%CI: 1.02-1.06, P = 0.001). Furthermore, among liver enzymes, blood lipids, and anthropometric indicators, the ALT/HDL-C ratio best predicts DM (AUC = 0.75, 95%CI: 0.73-0.78).
Increased ALT/HDL-C ratio levels at baseline correlated to incident DM. The relationship between ALT/HDL-C ratio and incident DM was also non-linear. When the ALT/HDL-C ratio is below 30.12, there is a statistically significant positive correlation between the ALT/HDL-C ratio and incident DM.
低水平的高密度脂蛋白胆固醇（HDL-C）和高水平的丙氨酸氨基转移酶（ALT）与胰岛素抵抗、代谢综合征和糖尿病（DM）有关。然而，关于丙氨酸氨基转移酶与高密度脂蛋白胆固醇（ALT/HDL-C）比值与糖尿病（DM）风险之间关系的证据有限。本研究旨在探讨日本人群中基线 ALT/HDL-C 比值与 DM 之间的关系。
这是一项基于队列研究的二次分析，使用开源数据。2004 年至 2015 年期间，日本村上纪念医院记录了参加体检计划的 15342 名个体的数据。采用平滑曲线拟合、亚组分析、Cox 比例风险回归和一系列敏感性分析来检查 ALT/HDL-C 比值与新发糖尿病之间的关系。使用受试者工作特征曲线分析评估 ALT/HDL-C 比值预测糖尿病的能力。
在控制混杂协变量后，发现日本成年人的 ALT/HDL-C 比值与 DM 风险呈正相关（HR：1.01，95%CI：1.00-1.02，P=0.049）。本研究还发现，在进行一系列敏感性分析后，ALT/HDL-C 比值与糖尿病之间存在稳定的关系。此外，ALT/HDL-C 比值与新发糖尿病之间存在非线性关系，ALT/HDL-C 比值拐点为 30.12。当 ALT/HDL-C 比值低于 30.12 时，本研究发现 ALT/HDL-C 比值与新发糖尿病之间存在显著正相关（HR：1.04，95%CI：1.02-1.06，P=0.001）。此外，在肝酶、血脂和人体测量指标中，ALT/HDL-C 比值最能预测 DM（AUC=0.75，95%CI：0.73-0.78）。
基线 ALT/HDL-C 比值升高与新发 DM 相关。ALT/HDL-C 比值与新发 DM 之间的关系也是非线性的。当 ALT/HDL-C 比值低于 30.12 时，ALT/HDL-C 比值与新发 DM 之间存在显著正相关。
