Correlation of liver enzymes with diabetes and pre-diabetes in middle-aged rural population in China

  • Jun-hui Xie (谢君辉)
  • Qian Liu (刘 倩)
  • Yan Yang (杨 雁)
  • Zhe-long Liu (刘哲隆)
  • Shu-hong Hu (胡蜀红)
  • Xin-rong Zhou (周新荣)
  • Gang Yuan (袁 刚)
  • Mu-xun Zhang (张木勋)
  • Jing Tao (陶 静)
  • Xue-feng Yu (余学锋)
Article

Summary

The survey aimed to explore the association of liver transaminases with the prevalence of type 2 diabetes mellitus (T2DM) and pre-diabetes (pre-DM) in the middle-aged rural population in China. A cross-sectional study was conducted in 10 800 middle-aged subjects who lived in rural area of central China. The 75-g oral glucose-tolerance test (OGTT) was performed. Participants were asked to complete physical examination and standard questionnaire. The serum liver transaminases (ALT and GGT), HbA1C and serum lipids were measured. In middle-aged rural population, the prevalence of impaired fasting glucose (IFG), impaired glucose tolerance (IGT), impaired fasting glucose combined with impaired glucose tolerance (IFG+IGT) and DM was 4.0%, 11.8%, 2.6% and 10.0%, respectively. Some measurements were higher in males than in females, such as waist hip ratio (WHR), blood pressure, fasting blood glucose (FBG), high density lipoprotein-cholesterol (HDL-C), and liver enzymes (ALT and GGT). Further, we found that elevated serum GGT and ALT levels were significantly positively correlated with the prevalence of DM, independent of central obesity, serum lipid and insulin resistance (IR) in both genders. However, the correlation of GGT and ALT with pre-DM was determined by genders and characteristics of liver enzymes. Higher serum GGT was indicative of IGT in both genders. The association of serum ALT with pre-DM was significant only in female IGT group. In conclusion, our present survey shows both serum GGT and ALT are positively associated with DM, independent of the cardiovascular risk factors in both genders.

Key words

type 2 diabetes mellitus pre-diabetes live enzymes γ-glutamyltransferase alanine aminotransferase 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract, 2010,87(1):4–14CrossRefPubMedGoogle Scholar
  2. 2.
    Abbasi A, Bakker SJ, Corpeleijn E, et al. Liver function tests and risk prediction of incident type 2 diabetes: evaluation in two independent cohorts. PloS one, 2012,7(12):e51496Google Scholar
  3. 3.
    Li R, Lu W, Jiang QW, et al. Increasing prevalence of type 2 diabetes in Chinese adults in Shanghai. Diabetes Care, 2012,35(5):1028–1030PubMedCentralCrossRefPubMedGoogle Scholar
  4. 4.
    Whitfield JB. Gamma glutamyl transferase. Crit Rev Clin Lab Sci, 2001,38(4):263–355CrossRefPubMedGoogle Scholar
  5. 5.
    Vozarova B, Stefan N, Lindsay RS, et al. High alanine aminotransferase is associated with decreased hepatic insulin sensitivity and predicts the development of type 2 diabetes. Diabetes, 2002,51(6):1889–1895CrossRefPubMedGoogle Scholar
  6. 6.
    Hanley AJ, Williams K, Festa A, et al. Elevations in markers of liver injury and risk of type 2 diabetes: the insulin resistance atherosclerosis study. Diabetes, 2004,53(10):2623–2632CrossRefPubMedGoogle Scholar
  7. 7.
    Andre P, Balkau B, Born C, et al. Three-year increase of gamma-glutamyltransferase level and development of type 2 diabetes in middle-aged men and women: the D.E.S.I.R. cohort. Diabetologia, 2006,49(11):2599–2603PubMedCentralCrossRefPubMedGoogle Scholar
  8. 8.
    Andre P, Balkau B, Born C, et al. Hepatic markers and development of type 2 diabetes in middle aged men and women: a three-year follow-up study. The D.E.S.I.R. Study (Data from an Epidemiological Study on the Insulin Resistance syndrome). Diabetes Metab, 2005,31(6):542–550CrossRefPubMedGoogle Scholar
  9. 9.
    Lee DH, Jacobs DR Jr, Gross M, et al. Gammaglutamyltransferase is a predictor of incident diabetes and hypertension: the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Clin Chem, 2003, 49(8):1358–1366.CrossRefPubMedGoogle Scholar
  10. 10.
    Nakanishi N, Suzuki K, Tatara K. Serum gammaglutamyltransferase and risk of metabolic syndrome and type 2 diabetes in middle-aged Japanese men. Diabetes Care, 2004,27(6):1427–1432CrossRefPubMedGoogle Scholar
  11. 11.
    Nakanishi N, Nishina K, Li W, et al. Serum gammaglutamyltransferase and development of impaired fasting glucose or type 2 diabetes in middle-aged Japanese men. J Intern Med, 2003,254(3):287–295CrossRefPubMedGoogle Scholar
  12. 12.
    Gao F, Pan JM, Hou XH, et al. Liver enzymes concentrations are closely related to prediabetes: findings of the Shanghai Diabetes Study II (SHDS II). Biomed Environ Sci, 2012,25(1):30–37PubMedGoogle Scholar
  13. 13.
    Nannipieri M, Gonzales C, Baldi S, et al. Liver enzymes, the metabolic syndrome, and incident diabetes: the Mexico City diabetes study. Diabetes Care, 2005,28(7):1757–1762CrossRefPubMedGoogle Scholar
  14. 14.
    Alberti KG, Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabet Med, 1998,15(7):539–553CrossRefPubMedGoogle Scholar
  15. 15.
    Sun J, Ren J, Pang ZC, et al. The association of gammaglutamyltransferase and C-reactive protein with IFG/IGT in Chinese adults in Qingdao, China. Clin Chim Acta, 2011,412(17–18):1658–1661CrossRefPubMedGoogle Scholar
  16. 16.
    Wen J, Liang Y, Wang F, et al. C-reactive protein, gammaglutamyltransferase and type 2 diabetes in a Chinese population. Clin Chim Acta, 2010,411(3–4):198–203CrossRefPubMedGoogle Scholar
  17. 17.
    Niccoli G, Della Bona R, Cosentino N, et al. Serum levels of gamma-glutamyltransferase and progression of coronary atherosclerosis. Coron Artery Dis, 2013,24(1):40–47CrossRefPubMedGoogle Scholar
  18. 18.
    Yamada J, Tomiyama H, Yambe M, et al. Elevated serum levels of alanine aminotransferase and gamma glutamyltransferase are markers of inflammation and oxidative stress independent of the metabolic syndrome. Atherosclerosis, 2006,189(1):198–205CrossRefPubMedGoogle Scholar
  19. 19.
    Lee CC, Adler AI, Sandhu MS, et al. Association of Creactive protein with type 2 diabetes: prospective analysis and meta-analysis. Diabetologia, 2009,52(6):1040–1047CrossRefPubMedGoogle Scholar
  20. 20.
    O'Brien RM, Granner DK. Regulation of gene expression by insulin. Biochem J, 1991,278(Pt 3):609–619PubMedCentralCrossRefPubMedGoogle Scholar

Copyright information

© Huazhong University of Science and Technology and Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Jun-hui Xie (谢君辉)
    • 1
  • Qian Liu (刘 倩)
    • 1
  • Yan Yang (杨 雁)
    • 1
  • Zhe-long Liu (刘哲隆)
    • 1
  • Shu-hong Hu (胡蜀红)
    • 1
  • Xin-rong Zhou (周新荣)
    • 1
  • Gang Yuan (袁 刚)
    • 1
  • Mu-xun Zhang (张木勋)
    • 1
  • Jing Tao (陶 静)
    • 1
  • Xue-feng Yu (余学锋)
    • 1
  1. 1.Department of Endocrinology, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina

Personalised recommendations