Skip to main content
SpringerLink
Log in

Coexistence of non-alcoholic fatty liver disease with elevated alanine aminotransferase is associated with insulin resistance in young Han males

  • Original Article
  • Published:
Endocrine Aims and scope Submit manuscript

Abstract

Elevated alanine aminotransferase (ALT) and non-alcoholic fatty liver disease (NAFLD) have been associated with insulin resistance (IR). The objective of this study was to determine whether elevated ALT and NAFLD were useful for early and definitive determination of IR and to compare their coexistence with conventional risk factors in young Han males. Anthropometric and metabolic measurements were assessed in 216 young Han males (19.3 ± 0.8 years). NAFLD was diagnosed using ultrasonography, and the homeostasis model assessment of insulin resistance (HOMA-IR) served as an index of IR. Subjects in the fourth HOMA-IR quartile had a significantly higher frequency of abdominal obesity, elevated blood pressure and ALT, and NAFLD compared to subjects in quartiles 1–3 (P < 0.05). Using multivariate logistic regression analysis, risk of IR increased by 2.33-fold (95% CI: 1.00–5.42, P = 0.050) in participants with NAFLD. In addition, the coexistence of NAFLD and elevated ALT were significantly associated with HOMA-IR and participants with both elevated ALT and NAFLD had a 4.65-fold (95% CI: 1.55–13.97, P = 0.006) increased risk of IR. Coexistence of NAFLD and elevated ALT are associated with IR in young Han males and might be useful for early detection of IR as compared to conventional risk factors.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. T. Watanabe, T. Suguro, K. Sato, T. Koyama, M. Nagashima, S. Kodate, T. Hirano, M. Adachi, M. Shichiri, A. Miyazaki, Serum salusin-alpha levels are increased and correlated negatively with carotid atherosclerosis in essential hypertensive patients. Hypertens. Res. 31, 463–468 (2008)

    Article  PubMed  CAS  Google Scholar 

  2. J.P. Strong, G.T. Malcom, C.A. McMahan, R.E. Tracy, W.P. Newman 3rd, E.E. Herderick, J.F. Cornhill, Prevalence and extent of atherosclerosis in adolescents and young adults: implications for prevention from the Pathobiological Determinants of Atherosclerosis in Youth Study. JAMA 281, 727–735 (1999)

    Article  PubMed  CAS  Google Scholar 

  3. I. Grattagliano, P. Portincasa, V.O. Palmieri, G. Palasciano, Managing nonalcoholic fatty liver disease: recommendations for family physicians. Can. Fam. Physician 53, 857–863 (2007)

    PubMed  Google Scholar 

  4. C.M. Ferrara, A.P. Goldberg, Limited value of the homeostasis model assessment to predict insulin resistance in older men with impaired glucose tolerance. Diabetes Care 24, 245–249 (2001)

    Article  PubMed  CAS  Google Scholar 

  5. J. Yoo, S. Lee, K. Kim, S. Yoo, E. Sung, J. Yim, Relationship between insulin resistance and serum alanine aminotransferase as a surrogate of NAFLD (nonalcoholic fatty liver disease) in obese Korean children. Diabetes Res. Clin. Pract. 81, 321–326 (2008)

    Article  PubMed  CAS  Google Scholar 

  6. D.F. Chan, A.M. Li, W.C. Chu, M.H. Chan, E.M. Wong, E.K. Liu, I.H. Chan, J. Yin, C.W. Lam, T.F. Fok, E.A. Nelson, Hepatic steatosis in obese Chinese children. Int. J. Obes. Relat. Metab. Disord. 28, 1257–1263 (2004)

    Article  PubMed  CAS  Google Scholar 

  7. G. Marchesini, M. Brizi, A.M. Morselli-Labate, G. Bianchi, E. Bugianesi, A.J. McCullough, G. Forlani, N. Melchionda, Association of nonalcoholic fatty liver disease with insulin resistance. Am. J. Med. 107, 450–455 (1999)

    Article  PubMed  CAS  Google Scholar 

  8. A. Sonsuz, M. Basaranoglu, M. Bilir, H. Senturk, P. Akin, Hyperinsulinemia in nondiabetic, both obese and nonobese patients with nonalcoholic steatohepatitis. Am. J. Gastroenterol. 97, 495 (2002)

    Article  PubMed  Google Scholar 

  9. P. Angulo, Nonalcoholic fatty liver disease. N. Engl. J. Med. 346, 1221–1231 (2002)

    Article  PubMed  CAS  Google Scholar 

  10. T.S. Burgert, S.E. Taksali, J. Dziura, T.R. Goodman, C.W. Yeckel, X. Papademetris, R.T. Constable, R. Weiss, W.V. Tamborlane, M. Savoye, A.A. Seyal, S. Caprio, Alanine aminotransferase levels and fatty liver in childhood obesity: associations with insulin resistance, adiponectin, and visceral fat. J. Clin. Endocrinol. Metab. 91, 4287–4294 (2006)

    Article  PubMed  CAS  Google Scholar 

  11. S. Deivanayagam, B.S. Mohammed, B.E. Vitola, G.H. Naguib, T.H. Keshen, E.P. Kirk, S. Klein, Nonalcoholic fatty liver disease is associated with hepatic and skeletal muscle insulin resistance in overweight adolescents. Am. J. Clin. Nutr. 88, 257–262 (2008)

    PubMed  CAS  Google Scholar 

  12. E.S. Ford, C. Li, G. Zhao, Prevalence and correlates of metabolic syndrome based on a harmonious definition among adults in the US. J. Diabetes 2, 180–193 (2010)

    Article  PubMed  Google Scholar 

  13. Z.J. Yang, W.Y. Yang, X.P. Chen, G.W. Li, The optimal waist circumference cut-off point for identifying cardiovascular risk factors clustering among Chinese adults. Zhonghua Nei Ke Za Zhi 45, 372–375 (2006). (in Chinese)

    PubMed  Google Scholar 

  14. G.C. Farrell, S. Chitturi, G.K. Lau, J.D. Sollano, Asia-Pacific Working Party on NAFLD, Guidelines for the assessment and management of non-alcoholic fatty liver disease in the Asia-Pacific region: executive summary. J. Gastroenterol. Hepatol. 22, 775–777 (2007)

    Article  PubMed  Google Scholar 

  15. Expert Panel on Detection, Evaluation, Treatment of High Blood Cholesterol in Adult, Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 285, 2486–2497 (2001)

    Article  Google Scholar 

  16. D. Prati, E. Taioli, A. Zanella, E. Della Torre, S. Butelli, E. Del Vecchio, L. Vianello, F. Zanuso, F. Mozzi, S. Milani, D. Conte, M. Colombo, G. Sirchia, Updated definitions of healthy ranges for serum alanine aminotransferase levels. Ann. Intern. Med. 137, 1–10 (2002)

    PubMed  CAS  Google Scholar 

  17. A.A. Patel, D.M. Torres, S.A. Harrison, Effect of weight loss on nonalcoholic fatty liver disease. J. Clin. Gastroenterol. 43, 970–974 (2009)

    Article  PubMed  Google Scholar 

  18. J.G. Fan, G.C. Farrell, Epidemiology of non-alcoholic fatty liver disease in China. J. Hepatol. 50, 204–210 (2009)

    Article  PubMed  Google Scholar 

  19. Y. Eguchi, T. Eguchi, T. Mizuta, Y. Ide, T. Yasutake, R. Iwakiri, A. Hisatomi, I. Ozaki, K. Yamamoto, Y. Kitajima, Y. Kawaguchi, S. Kuroki, N. Ono, Visceral fat accumulation and insulin resistance are important factors in nonalcoholic fatty liver disease. J. Gastroenterol. 41, 462–469 (2006)

    Article  PubMed  CAS  Google Scholar 

  20. G. Musso, R. Gambino, S. Bo, B. Uberti, G. Biroli, G. Pagano, M. Cassader, Should nonalcoholic fatty liver disease be included in the definition of metabolic syndrome? A cross-sectional comparison with Adult Treatment Panel III criteria in nonobese nondiabetic subjects. Diabetes Care 31, 562–568 (2008)

    Article  PubMed  CAS  Google Scholar 

  21. J.G. Fan, Y.D. Peng, Metabolic syndrome and non-alcoholic fatty liver disease: Asian definitions and Asian studies. Hepatobiliary Pancreat. Dis. Int. 6, 572–578 (2007)

    PubMed  Google Scholar 

  22. A.J. Hanley, L.E. Wagenknecht, A. Festa, R.B. D’Agostino Jr, S.M. Haffner, Alanine aminotransferase and directly measured insulin sensitivity in a multiethnic cohort: the Insulin Resistance Atherosclerosis Study. Diabetes Care 30, 1819–1827 (2007)

    Article  PubMed  CAS  Google Scholar 

  23. C.C. Fu, M.C. Chen, Y.M. Li, T.T. Liu, L.Y. Wang, The risk factors for ultrasound-diagnosed non-alcoholic fatty liver disease among adolescents. Ann. Acad. Med. Singap. 38, 15–17 (2009)

    PubMed  Google Scholar 

  24. M.R. Salazar, H.A. Carbajal, J.O. Curciarello, M. Aizpurua, R.E. Adrover, B. Riondet, Alanin-aminotransferase: an early marker for insulin resistance? Medicina (B Aires) 67, 125–130 (2007)

    CAS  Google Scholar 

  25. S.H. Park, B.I. Kim, H.J. Kim, H. Kim, S.H. Kim, D.I. Park, Y.K. Cho, I.K. Sung, C.I. Sohn, W.K. Jeon, D.K. Keum, Clinical features associated with improvement of fatty liver disease. Intern. Med. J. 35, 473–477 (2005)

    Article  PubMed  CAS  Google Scholar 

  26. J.D. Browning, L.S. Szczepaniak, R. Dobbins, P. Nuremberg, J.D. Horton, J.C. Cohen, S.M. Grundy, H.H. Hobbs, Prevalence of hepatic steatosis in an urban population in the United States: impact of ethnicity. Hepatology 40, 1387–1395 (2004)

    Article  PubMed  Google Scholar 

  27. M.H. Fishbein, C. Mogren, T. Gleason, W.R. Stevens, Relationship of hepatic steatosis to adipose tissue distribution in pediatric nonalcoholic fatty liver disease. J. Pediatr. Gastroenterol. Nutr. 42, 83–88 (2006)

    PubMed  Google Scholar 

  28. H.M. Yan, X. Gao, M. Liu, Q. Gu, B. Zhang, X. Li, Relationship of liver fat content to insulin resistance and metabolic syndrome. Zhonghua Yi Xue Za Zhi 88, 1255–1258 (2008). (in Chinese)

    PubMed  CAS  Google Scholar 

  29. S.Y. Oh, Y.K. Cho, M.S. Kang, T.W. Yoo, J.H. Park, H.J. Kim, D.I. Park, C.I. Sohn, W.K. Jeon, B.I. Kim, B.H. Son, J.H. Shin, The association between increased alanine aminotransferase activity and metabolic factors in nonalcoholic fatty liver disease. Metabolism 55, 1604–1609 (2006)

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

The authors are grateful for the support and cooperation of the universities in Qinhuangdao.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Endocrinology, First Hospital of Qinhuangdao, No. 258 Wenhua Road, Qinhuangdao, Hebei, 066000, China

    Rui Wang, Qiang Lu, Ji Feng, Fuzai Yin, Chunmei Qin, Bo Liu, Yali Liu & Xiaoli Liu

Authors
  1. Rui Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Qiang Lu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ji Feng
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Fuzai Yin
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Chunmei Qin
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Bo Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yali Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Xiaoli Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Qiang Lu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Wang, R., Lu, Q., Feng, J. et al. Coexistence of non-alcoholic fatty liver disease with elevated alanine aminotransferase is associated with insulin resistance in young Han males. Endocrine 41, 70–75 (2012). https://doi.org/10.1007/s12020-011-9511-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12020-011-9511-0

Keywords

Search

Navigation