The Correlation Study Between Liver Enzymes And The Level Of Glycometabolism

Objective To observe the change trend of the levels of serum alanine aminotransferase (ALT), aspertate aminotransferase (AST) and gamma-glutamyl transpeptidase (GGT) in different glycometabolism states, analyzed the risk factors of these enzymes, and investigate the relationships between them and the risk of diabetes mellitus.Methods A cross-sectional study of cluster sampling was performed in LanZhou City with a representative sample of community residents aged from40years to75years. Questionnaire was conducted. Height, Weight, waist circumference, and blood pressure were measured, body mass index (BMI) were calculated. Fasting blood glucose (FPG), postprandial2h blood glucose (2hPG), glycated hemoglobin (HbAlC), total cholesterol (CHOL), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and alanine aminotransferase (ALT), aspertate aminotransferase (AST) and gamma-glutamyl transpeptidase were tested. Respectively compared the difference of serum ALT, AST and GGT among the normal glucose tolerance (NGT) group, impaired glucose regulation (IGR) group and diabetes mellitus (DM) group, and analyzed correlation between them and the risk of diabetes mellitus. Meanwhile, investigate the mechanism of how liver markers affect in diabetes mellitus.Results l.We selected974subjects in the present analyses. Including257males(28.2%) and699females(71.8%).1. There were540subjects of normal glucose regulation,257subjects of IGR,177diabetic patients newly diagnosed. The proportions were55.4%,55.4%and18.2%respectively.2. Serum liver marker levels in patients of IGR and DM were significantly elevated compared with NGT (P<0.05). Compared with IGR group, the level of GGT in DM group was higher (P<0.01).3. In the Pearson correlation, serum ALT levels were correlated positively with Weight, TG, WC, BMI,2hPG, FPG, DBP, HbAlc and CHOL, and negatively correlated with Sex(male), HDL-C and age (P<0.05). Serum AST levels correlated positively with TG, WC, BMI, DBP, Weight,2hPG, SBP and CHOL (P<0.01). Serum GGT levels correlated positively with TG, WC,2hPG, FPG, BMI, HbAlc, DBP, CHOL, SBP, LDL-C and Weight (P<0.01), and negatively correlated with Sex(male) and HDL-C (P<0.05). After control of the Sex, Age, BMI and WC, serum ALT levels correlated positively with TG,2hPG, CHOL, FPG and HbAlc (P<0.05). Serum AST levels correlated positively with TG, HDL-C, DBP and CHOL (P<..05). Serum GGT levels correlated positively with TG, CHOL,2hPG, HbAlc, FBP and LDL-C (P<0.01).4. Method of stepwise linear regression analysis showed that TG, Age, Sex(male),2hPG, WC, BMI and HDL-C were the independent factors of serum ALT (P<0.05).LDL-C,CHOL, WC and2hPG were the independent factors of serum AST (P<0.05). LDL-C, TG, HDL-C, CHOL, Weight and2hPG were the independent factors of serum GGT (P<0.05).5. With the increase of serum ALT and GGT levels, prevalence of diabetes increased gradually. Adjusted the factors, such as Sex, Age, BMI, WC, HDL-C, LDL-C, CHOL, TG, SBP and DBP, the risk of diabetes increased along with the rise of serum ALT and GGT levels, top one-fifth versus bottom one-fifth relative risks for diabetes prevalence were:ALT:3.438(95%C7:1.531～7.721); GGT:3.627(95%CI:1.756～7.491). After continuing adjustment for the other two en2ymes, the risks for diabetes mellitus prevalence were:ALT:12.983(95%CI:3.370～50.016), GGT:3.311(95%CI:1.492～7.350).Conclusions Our research suggests that serum ALT, AST and GGT were closely related to abnormal glucose metabolism and diabetes. They were the risk markers for diabetes mellitus. The risk of diabetes mellitus increased along with the rise of serum ALT and GGT levels. Elevated liver enzymes levels may be the predictor of diabetes mellitus.