Department of Endocrinology and Metabolism, The Affiliated Hospital of Qingdao University, Qingdao, China.
Department of Nursing and Hospital Infection Management, The Affiliated Hospital of Qingdao University, Qingdao, China.
Front Endocrinol (Lausanne). 2024 Apr 3;15:1361707. doi: 10.3389/fendo.2024.1361707. eCollection 2024.
This study aimed to explore the association between the aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT ratio) and diabetic retinopathy (DR) in patients with type 2 diabetes.
In this cross-sectional study, clinical data from 3002 patients with type 2 diabetes admitted to the Department of Endocrinology of our hospital between January 1, 2021, and December 1, 2022, were retrospectively collected. Measurements of AST and ALT were conducted and diabetes-related complications were screened. The association between AST/ALT ratio and diabetic retinopathy was assessed using multivariate logistic regression, and a generalized additive model (GAM) was used to investigate nonlinear relationships. Subgroup analyses and interaction tests were also conducted.
Among the 3002 patients, 1590 (52.96%) were male and 1412 (47.04%) were female. The mean AST/ALT ratio was 0.98 ± 0.32, ranging from 0.37 (Min) to 2.17 (Max). Diabetic retinopathy was present in 40.47% of the patients. After multivariate adjustments, for each 0.1 unit increase in AST/ALT ratio, the risk of DR increased by 4% (OR = 1.04, 95% CI: 1.01-1.07, p=0.0053). Higher AST/ALT ratio quartiles were associated with Higher prevalence of DR (OR . Q1: Q4 = 1.34 (CI: 1.03-1.75, p=0.0303).The GAM and smoothed curve fit indicated a linear relationship between AST/ALT ratio and DR risk, with no significant interaction effects across different subgroups.
Our study demonstrates a positive correlation between the AST/ALT ratio and diabetic retinopathy risk in type 2 diabetes, suggesting its potential role in assessing DR risk.
本研究旨在探讨 2 型糖尿病患者天门冬氨酸氨基转移酶/丙氨酸氨基转移酶比值（AST/ALT 比值）与糖尿病视网膜病变（DR）之间的关系。
本横断面研究回顾性收集了 2021 年 1 月 1 日至 2022 年 12 月 1 日期间我院内分泌科收治的 3002 例 2 型糖尿病患者的临床资料。检测 AST 和 ALT，并筛查糖尿病相关并发症。采用多变量 logistic 回归评估 AST/ALT 比值与糖尿病视网膜病变的关系，并采用广义加性模型（GAM）探讨非线性关系。还进行了亚组分析和交互检验。
在 3002 例患者中，1590 例（52.96%）为男性，1412 例（47.04%）为女性。AST/ALT 比值的平均值为 0.98±0.32，范围从 0.37（最小值）到 2.17（最大值）。40.47%的患者患有糖尿病视网膜病变。经过多变量调整后，AST/ALT 比值每增加 0.1 单位，DR 的风险增加 4%（OR=1.04，95%CI：1.01-1.07，p=0.0053）。较高的 AST/ALT 比值四分位间距与较高的 DR 患病率相关（OR Q1：Q4=1.34（CI：1.03-1.75，p=0.0303）。GAM 和平滑曲线拟合表明，AST/ALT 比值与 DR 风险之间存在线性关系，不同亚组之间没有显著的交互作用。
本研究表明，2 型糖尿病患者 AST/ALT 比值与糖尿病视网膜病变风险呈正相关，提示其在评估 DR 风险方面具有潜在作用。
