BackgroundWe examined the association between liver enzymes and development of type 2 diabetes in a general Korean population.MethodsA total of 10,667 subjects (4,201 males and 6,466 females) aged 45 to 74 years participated in a baseline examination between 2004 and 2007. Among the subjects, 8,157 (3,231 males and 4,926 females) underwent follow-up examination from 2007 to 2011, for a median follow-up period of 4.2 years. Type 2 diabetes was defined as intake of anti-diabetic agents, insulin treatment, fasting glucose concentration of more than 126 mg/dl, or hemoglobin A1c of more than 6.5% at re-examination. Associations of liver enzymes with incidence of type 2 diabetes were analyzed using logistic regression models.ResultsDuring the follow-up period, 548 subjects (235 males, 313 females) developed type 2 diabetes. After adjusting for comprehensive diabetes risk factor, the risk of type 2 diabetes was significantly higher in the highest alanine aminotransferase (ALT) quartile than in the lowest quartile (odds ratio (OR): 1.95, 95% confidence interval (CI): 1.18-3.21 in males; OR: 1.49, 95% CI: 1.03-2.16 in females). Similar results were observed for gamma-glutamyltransferase (GGT) quartiles, but in the fully adjusted analysis, the OR for the highest versus lowest quartiles was significant only for females (OR: 1.58, 95% CI: 0.95-2.63 in males; OR: 1.85, 95% CI: 1.23-2.79 in females).ConclusionsOur results suggest that serum ALT concentrations were independently associated with type 2 diabetes in both sexes, and that GGT was also independently associated but only in females.

BackgroundWe investigated the association of cumulative smoking exposure and duration of smoking cessation with peripheral arterial disease (PAD).MethodsThe study population consisted of 2517 community-dwelling Korean men aged 50 years and older. Information on smoking characteristics such as smoking status, pack-years of smoking, and years since quitting smoking was collected using a standardized questionnaire. PAD was defined as an ankle-brachial index (ABI) less than 0.90 in either leg.ResultsThe odds ratio (OR, 95% confidence interval) of PAD was 2.31 (1.20-4.42) for former smokers and 4.30 (2.13-8.66) for current smokers, after adjusting for other cardiovascular risk factors. There was a significant dose-response relationship between pack-years of smoking and PAD. Compared with those who had never smoked, the multivariate-adjusted ORs of PAD for smokers of 0.1-20.0, 20.1-40.0, and >40.0 pack-years were 2.15 (1.06-4.38), 2.24 (1.08-4.65), and 2.93 (1.41-6.09), respectively. There was a significant decrease in PAD risk as the years since quitting smoking increased. The multivariate-adjusted ORs of PAD for 11-20 and ≥21 years smoking cessation were 0.41 (0.19-0.86) and 0.49 (0.24-0.98), compared with current smokers.ConclusionsCumulative smoking exposure and duration of smoking cessation were significantly associated with PAD in middle aged and older Korean men.

Recent studies have shown that bilirubin is negatively associated with hemoglobin A1c (HbA1c) in the general population. The association between bilirubin and HbA1c in serum of diabetes patients has not yet been studied. The aim of the present study was to evaluate the association between total bilirubin and HbA1c in Korean patients with type 2 diabetes. A total of 690 of the 1,275 type 2 diabetes patients registered with the public health centers in Seo-gu, Gwangju and Gokseong-gun, Jeollanam-do participated in this study. Following an overnight fast, venous blood and urine samples were collected and analyzed. The mean HbA1c values differed significantly according to total bilirubin (≤ 0.4 mg/dL, 7.6%; 0.5 mg/dL, 7.3%; 0.6-0.7 mg/dL, 7.2%; and ≥ 0.8 mg/dL, 7.1%; P for trend = 0.016) after we adjusted for other confounding factors. When the odds ratio (OR) was adjusted for other confounding factors, there was a significant association between total bilirubin and HbA1c (OR, 0.4 [95% confidence interval, 0.2-0.8] for total bilirubin ≥ 0.8 mg/dL versus ≤ 0.4 mg/dL. In conclusion, total bilirubin concentrations in serum are negatively associated with HbA1c levels after adjustment for sex, age, and other confounding factors in type 2 diabetes patients.

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