Department of Endocrinology and Metabolism, First Hospital of Jilin University, Changchun, China.
Department of Health Examination Center, First Hospital of Jilin University, Changchun, China.
Front Endocrinol (Lausanne). 2024 Feb 20;15:1340604. doi: 10.3389/fendo.2024.1340604. eCollection 2024.
This study aimed to examine the association of liver enzymes, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl-transferase (GGT), with type 2 diabetes (T2D) risk, particularly their dose-response relationship.
This cross-sectional study enrolled participants aged >20 years old who underwent physical examination at our local hospital from November 2022 to May 2023. A generalized additive model (GAM) was fit to assess the dose-response relationship between liver enzymes and T2D risk. Furthermore, data from the UK Biobank (n=217,533) and National Health and Nutrition Examination Survey (NHANES 2011-2018; n= 15,528) were analyzed to evaluate whether the dose-response relationship between liver enzymes and T2D differed by population differences.
A total of 14,100 participants were included (1,155 individuals with T2D and 12,945 individuals without diabetes) in the analysis. GAM revealed a non-linear relationship between liver enzymes and T2D risk ( < 0.001). Specifically, T2D risk increased with increasing ALT and GGT levels (range, <50 IU/L) and then plateaued when ALT and GGT levels were >50 IU/L. Elevated AST within a certain range (range, <35 IU/L) decreased the risk of T2D, whereas mildly elevated AST (>35 IU/L) became a risk factor for T2D. The UK Biobank and NHANES data analysis also showed a similar non-linear pattern between liver enzymes and T2D incidence.
Liver enzymes were non-linearly associated with T2D risk in different populations, including China, the UK, and the US. Elevated ALT and GGT levels, within a certain range, could increase T2D risk. More attention should be given to liver enzyme levels for early lifestyle intervention and early T2D prevention. Further studies are necessary to explore the mechanism of the non-linear association between liver enzymes and T2D risk.
本研究旨在探讨包括丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）和γ-谷氨酰转移酶（GGT）在内的肝酶与 2 型糖尿病（T2D）风险之间的关联，特别是它们的剂量-反应关系。
这项横断面研究纳入了 20 岁以上在我们当地医院进行体检的参与者。使用广义加性模型（GAM）评估肝酶与 T2D 风险之间的剂量-反应关系。此外，还分析了英国生物银行（n=217533）和美国国家健康和营养检查调查（NHANES 2011-2018；n=15528）的数据，以评估肝酶与 T2D 之间的剂量-反应关系是否因人群差异而不同。
共有 14100 名参与者（1155 名患有 T2D，12945 名无糖尿病）纳入分析。GAM 显示肝酶与 T2D 风险之间存在非线性关系（ < 0.001）。具体而言，随着 ALT 和 GGT 水平（范围<50IU/L）的升高，T2D 风险增加，当 ALT 和 GGT 水平>50IU/L 时趋于平稳。在一定范围内升高的 AST（范围<35IU/L）降低了 T2D 的风险，而轻度升高的 AST（>35IU/L）则成为 T2D 的危险因素。英国生物银行和 NHANES 数据分析也显示了肝酶与 T2D 发生率之间相似的非线性模式。
肝酶与不同人群（包括中国、英国和美国）的 T2D 风险呈非线性相关。在一定范围内，升高的 ALT 和 GGT 水平可能会增加 T2D 的风险。应更加关注肝酶水平，以便进行早期生活方式干预和早期 T2D 预防。需要进一步研究以探讨肝酶与 T2D 风险之间非线性关联的机制。
