The Interaction Between The Liver Enzymes And Obesity In Impaired Fasting Glucose And Type 2 Diabetes

Objective To explore the relationship and interaction between serum liver enzyme,obesity in impaired fasting glucose(IFG)and type 2 diabetes(T2DM).Methods From March 2011 to February 2012 who participated in the healthy examination served as the subjects of present study.Individuals who suffered from malignant tumor,viral hepatitis,severe mental illness and incomplete information were excluded and the present study includes 3774 subjects which contains 1478 males and 2296 females and aged from 18-88(51.35±14.48)years.The height,weight,blood pressure(BP),fasting plasma glucose(FPG),blood lipid,serum liver enzyme and renal function indexes were detected for all subjects.Those subjects were divided into three groups according to the FPG:the normal,the IFG,the T2DM.The one-way ANOVA was used to compare the mean of each clinical indicator among three different groups.The trend test among these indicators was evaluated by linear regression.The comparison in categorical variables was used chi-square test.The comparison and trend of various metabolic indexes of different serum aspartate transaminase(AST),alanine-aminotransferase(ALT)and y-glutamyltransferase(GGT)levels were used one-way ANOVA and linear regression respectively.The chi-square test was used to compare the difference of the prevalence of the IFG and T2DM.The multiple Logistic regression analysis was used to analyzed the association of the serum liver enzymes and the risk of IFG and T2DM and the interactionbetween liver enzymes and obesity in IFG and T2DM.Results 1.IFG group and T2DM group’s BMI,SBP,TG,TC,HDL,LDL-C,UA,BUN,Cr,AST,ALT,GGT,were higher than NGT group and raised as the abnormal serum glucose raised and the HDL-C was lower than NGT group and decreased as the abnormal serum glucose raised.The difference was statistically significant.2.With the increase of serum AST,ALT,and GGT levels,the prevalence of IFG and T2DM gradually increased.The levels of the BMI,SBP,DBP,TC,TG,LDL-C,FPG,UA,BUN,and Cr increased with the levels of the serum AST,ALT,GGT increasing.The levels of the HDL-C decreased with the levels of the serum AST,ALT,GGT increasing.3.Compared with Q1,the OR of the serum AST for the IFG and T2DM in Q4 is 2.16(95%CI:1.656-2.816)and 2.48(95%CI:1.775-3.456),the OR of the serum ALT for the IFG and T2DM in Q4 is 7.57(95%CI:5.117-11.206)and 8.49(95%CI:5.342-13.504),the OR of the serum GGT for the IFG and T2DM in Q4 is 7.45(95%CI:5.180-10.719)and 9.10(95%CI:5.783-14.318)when unadjusted.After adjusting age,sex,BMI,TC,TG,HDL-C,LDL-C,Cr,BUN,UA,SBP,DBP,compared with Q1,the OR of the serum ALT for the IFG and T2DM in Q4 is 4.42(95%CI:2.902-6.744)and 5.36(95%CI:3.362-8.802),the OR of the serum GGT for the IFG and T2DM in Q4 is 4.47(95%CI:2.914-6.855)and 6.98(95%CI:4.154-11.714).ALT was no longer associated with IFG and T2DM.There were interactions among AST,ALT,GGT and obesity in IFG and T2DM.After adjusting age,sex,BMI,blood lipid and other confounders,compared with Q1 in the normal weight,the OR of the serum AST in obesity for the IFG and T2DM in Q4 is 2.01(95%CI:1.126-3.932)and 2.10(95%CI:1.126-3.932),the OR of the serum ALT in obesity for the IFG and T2DM in Q4 is 8.62(95%CI:4.915-15.126)and 7.91(95%CI:4.127-15.159),the OR of the serum GGT in obesity for the IFG and T2DM in Q4 is 6.34(95%CI:3.983-10.101)and 8.69(95%CI:5.098-14.811).Conclusion 1.There were high risks of IFG and T2DM in high level of AST,ALT and GGT.After adjusting age,sex,BMI,blood lipid and other confounders,there was no relationship between AST and IFG and T2DM,however the high level of ALT,GGT levels were still associated with IFG and T2DM.2.The AST,ALT,GGT levels interacted with obesity in IFG and T2DM even if adjusting the confounders.