Study of relationship between serum alanine aminotransferase level and the different states of glucose metabolism

Objective To explore the association between serum alanine aminotransferase(ALT) level and the different states of glucose metabolism and investigate the relevant factors of serum ALT. Methods 871 subjects with high risk of diabetes mellitus(DM)in Beijing area underwent a 75g oral glucose tolerance test(OGTT) for screening of diabetes.The subjects were divided into three groups: NGT,IGR and T2DM according to the states of glucose metabolism.We compared serum ALT levels between three groups,analyzed the relationships between serum ALT and other variables and the relationship between serum ALT and the incidence of type 2 diabetes mellitus(T2DM). Results After adjusting age,BMI,waist circumference,TG and HDL-C,the newly diagnosed T2DM group had the highest serum ALT level(P=0.001).Correlation analysis indicated that the serum ALT was positively associated with BMI,waist circumference and HOMA-IR(r= 0.303,0.316 and 0.322,respectively).In a logistic regression analysis with adjustment for sex,age,BMI and waist circumference,elevated serum ALT was associated with an increase in the incidence of T2DM.Participants in the highest quartiles of ALT were at significantly increased risk of incident type 2 diabetes compared with those in the lowest quartiles : OR 2.16(1.41-3.32).After further adjustment for serum lipids and HOMA-IR,the association still remained but weakened. Conclusion Serum ALT could be associated with the incidence of type 2 diabetes independent of obesity,serum lipids,insulin sensitivity and secretion function.