Association of the higher alanine aminotransferase level in the normal range with cardiovascular risk clusters in the patients with T2DM

Objective To investigate the association between serum alanine aminotransferase(ALT) level in the normal range and the cardiovascular risk clusters in the Chinese patients with type 2 diabetes.Methods 4744 patients with type 2 diabetes were selected for evaluating the relationship between cardiovascular risk clusters and the ALT level.The causes of the abnormal high ALT level such as hepatitis,alcohol and drugs were excluded based on the past history,hospital examinations.4295 patients with normal ALT level were divided into 4 groups on the interquatile distances.The waist circumference,BMI,blood glucose,blood pressure,insulin and HOMA-IR,HbA1c,lipids,uric acid,urine albumin and the prevalence of the metabolic syndrome and its components were compared among these groups. Results The uric acid level was significantly higher along with the increased ALT,from(5.37±0.36) in group 1 to(5.50±0.35) μmol/L in group 4.Patients with highest ALT level had significantly higher fasting glucose and postprandial glucose.Metabolic syndrome prevalence was 45.1%,47.6%,47.6 % and 58.0% when ALT level was from lowest to highest.ALT level was significantly different between group 4 and other 3 groups(P=0.000 to 0.015).Central obesity prevalence in the four groups was 51.9%,51.2%,48.7%,60.2%,hypertriglyceridemia prevalence was 33.5%,41.6%,47.6%,58.0%,and high serum uric acid prevalence was 4.1%,6.0%,5.5% and 9.9%,respectively,with significant difference between group 1 and group 4. Conclusions The increase in ALT level in the normal range is associated with the cardiovascular risk clusters in diabetic patients.