Correlation Analysis Between Liver Enzymes And Type 2 Diabetes Mellitus

Objective:To investigate the correlation between liver enzymes and type 2 diabetes mellitus(T2DM)and to explore the application value of liver enzymes in the prevention and treatment of T2DM.Methods:The data were obtained from the Japanese Dryad dataset,a longitudinal analysis study followed up to 13 years,and the final analytic sample included 15,464 participants,373 of whom were finally diagnosed with T2DM.The basic information and laboratory test at baseline were collected.The data were divided into 4 groups according to the quartiles of liver enzymes[alanine aminotransferase(ALT),aspartate aminotransferase(AST),gamma-glutamyl transpeptidase(GGT)].The first quartile(Q1),the second quartile(Q2),the third quartile(Q3)and the fourth quartile(Q4)were analyzed and compared for the differences of various variables among the four groups.Kaplan-Meier method was used to analyze the cumulative risk of T2DM among the four groups.Multivariate COX regression model was used to evaluate the relationship between ALT,AST,GGT and T2DM risk after controlling for the possible influence of other factors,restriction cubic spline plots were used to obtain the cut-off values for liver enzymes..Results:1.With the increase of ALT,AST and GGT,glucose metabolism indicators[fasting blood glucose(FPG)and glycated hemoglobin(HbA1c)]also increased(P<0.001).2.The cumulative risk of T2DM in ALT,AST and GGT groups was significant(log-Rank test P<0.001).The cumulative risk of T2DM increased with the increase of ALT,AST and GGT,respectively.3.In the non-adjusted model,the hazard ratios(HR)of T2DM were 2.04[95%confidence interval,(95%CI):1.24,3.34)];3.62(95%CI:2.28,5.72);8(95%CI:5.21,12.31)for ALT quartiles 2-4 respectively,compared to ALT Q1.This association also existed after adjusting for all relevant factors,such as[general data(sex,age),lifestyle(smoking,alcohol consumption,exercise),general clinical indicators(systolic blood pressure,diastolic blood pressure,waist circumference,body mass index),and serological indicators(triglycerides,HDL,FPG,HbA1C)],1.97-fold higher risk of developing T2DM(HR=1.97,95%CI:1.21,3.23,P for trend=0.003)in the highest quartiles(concerning ALT levels)compared to the lowest quartiles.4.After adjusting for general data(sex,age)and lifestyle(smoking,alcohol),3.03-fold higher risk of developing T2DM(HR=3.03,95%CI:2.14,4.28,P for trend<0.001)in the highest quartiles(concerning AST levels)compared to the lowest quartiles,while after further adjusting for all relevant factors,no statistical significance was found among the groups(P for trend=0.714).5.Before the glucose metabolism indicators(FPG,HbA1c)was adjusted,compared to the lowest quartiles,HR were 1.66(95%CI:0.98,2.80),2.14(95%CI:1.27,3.60),2.95(95%CI:1.73,5.00)for GGT quartiles 2-4,respectively(P for trend<0.009),but after adjusting for glucose metabolism indexes,there was no statistically significant difference among the four groups(P for trend=0.031).Conclusion:1.ALT is an independent risk factor for T2DM,while AST and GGT are not.2.With the increase of ALT,the risk of T2DM increase,so ALT can be used as a serological indicator for the risk assessment of T2DM.