Association Between Aspartate Aminotransferase to Alanine Aminotransferase Ratio and Incidence of Type 2 Diabetes Mellitus in the Japanese Population: A Secondary Analysis of a Retrospective Cohort Study

Chen, Lidan; Zhang, Kebao; Li, Xue; Wu, Yang; Liu, Qingwen; Xu, Li‐Yan; Li, Liuyan; Hu, Haofei

doi:10.2147/dmso.s337416

Cited by 10 publications

(11 citation statements)

References 45 publications

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Section: Discussioncontrasting

confidence: 67%

“…However, diabetes risk scores developed on the basis of specific ethnicities might not be applicable to other ethnic groups (34). Thus, the inflection point of 1.18 was apparently higher in the Chinese population compared to the previous studies that explored an inflection point of 0.93 and 0.88 in the Japanese population (16,33). Many diabetes could be prevented by lifestyle improvements, such as maintaining a healthy weight and diet and increasing exercise, thus necessitating early identification of populations at high risk for early preventive measures (19).…”

Section: Discussionmentioning

confidence: 65%

“…Similarly, surveys based on American populations revealed an increased risk of insulin resistance with lower AST/ALT ratio ( 32 ). Since insulin resistance is an important characteristic of diabetes, several recent studies based on Japanese populations also further elucidated a conclusion that there was also a correlation between low AST/ALT ratio and the incidence of diabetes ( 15 , 16 , 33 ). And they demonstrated that AST/ALT ratio was non-linearly associated with diabetes risk.…”

Section: Discussionmentioning

confidence: 98%

“…At the same time, it has been reported that high ALT/AST ratio are strongly associated with insulin resistance and insulin resistance-related diseases in the Korean population ( 14 ). Further studies have shown that a low AST/ALT ratio is an ideal predictor of the incidence of diabetes in Japanese ( 15 , 16 ).…”

Section: Introductionmentioning

confidence: 99%

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Low aspartate aminotransferase/alanine aminotransferase (DeRitis) ratio assists in predicting diabetes in Chinese population

Xie

Yu²,

Chen³

et al. 2022

Front. Public Health

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BackgroundFew studies discussed the predictive ability of aspartate aminotransferase/alanine aminotransferase (AST/ALT, DeRitis) ratio for diabetes risk. The aim of this study was to characterize the role of AST/ALT ratio in the prediction of Chinese diabetes.MethodsThis retrospective cohort study analyzed a Chinese population comprising 87,883 participants without diabetes at baseline between 2010 and 2016. Cox proportional hazards regression was used to identify independent risk factors. Restricted cubic spline (RCS) was performed to investigate the non-linear correlation between AST/ALT ratio and diabetes risk.ResultsDuring a median follow-up period of 3.01 years, 1,877 participants developed diabetes. Comparing the baseline characteristics, diabetes group exhibited lower AST/ALT ratio. The Kaplan-Meier curve showed that participants with low AST/ALT ratio had higher cumulative incidence, and Cox regression also demonstrated that the lower AST/ALT ratio, the higher diabetes risk (HR: 0.56, 95% CI: 0.37–0.85, P = 0.006). The RCS model revealed a non-linear correlation between AST/ALT ratio and diabetes risk. In the condition of AST/ALT ratio ≤1.18, diabetes risk increased as it decreased (HR: 0.42, 95% CI: 0.19–0.91, P = 0.028). In contrast, AST/ALT ratio did not independently affect diabetes when beyond 1.18.ConclusionAST/ALT ratio is a valuable predictor of diabetes. Diabetes risk increases rapidly in the condition of AST/ALT ratio ≤1.18.

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Section: Discussioncontrasting

confidence: 67%

Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Low aspartate aminotransferase/alanine aminotransferase (DeRitis) ratio assists in predicting diabetes in Chinese population

Xie

Yu²,

Chen³

et al. 2022

Front. Public Health

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“…A previous study found that AST/ALT can affect the risk of T2DM ( 14 ). The AST/ALT ratio independently has negative association with the risk of developing T2DM, and the relationship was non-linear ( 15 ). In addition, the measurement of these liver enzymes involves well-standardized, simple, inexpensive, and routine tests that do not require fasting before venipuncture, suggesting that they could be incorporated in scores to predict diabetes risk ( 16 ).…”

Section: Introductionmentioning

confidence: 99%

AST-to-ALT ratio in the first trimester and the risk of gestational diabetes mellitus

Zhang

et al. 2022

Front. Endocrinol.

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BackgroundAspartate aminotransferase-to-alanine transaminase ratio (AST/ALT) has been reported affect the risk of type 2 diabetes (T2DM), but it is uncertain if it has relationship with gestational diabetes mellitus (GDM).ObjectivesOur study aimed to investigate the association between AST/ALT ratio in the first trimester and the risk of subsequent development of GDM.MethodThis prospective cohort study enrolling 870 pregnant women, 204 pregnant women with missing data or liver diseases were excluded, 666 pregnant women were included in this study containing 94 GDM women. Blood samples were collected in the first trimester. Univariate analysis and multivariate logistic regression were used to evaluate the association between AST/ALT and GDM. Nomogram was established based on the results of multivariate logistic analysis. Receiver Operating Characteristic (ROC) curves and calibration curves were used to evaluate the predictive ability of this nomogram model for GDM. Decision curve analysis (DCA) was used to examine the clinical net benefit of predictive model.ResultsAST/ALT ratio (RR:0.228; 95% CI:0.107-0.488) was associated with lower risk of GDM after adjusting for confounding factors. Indicators used in nomogram including AST/ALT, maternal age, preBMI, waist circumference, glucose, triglycerides, high density lipoprotein cholesterol and parity. The area under the ROC curve (AUC) value of this predictive model was 0.778, 95% CI (0.724, 0.832). Calibration curves for GDM probabilities showed acceptable agreement between nomogram predictions and observations. The DCA curve demonstrated a good positive net benefit in the predictive model.ConclusionsThe early AST/ALT level of pregnant women negatively correlated with the risk of GDM. The nomogram including AST/ALT at early pregnancy shows good predictive ability for the occurrence of GDM.

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Association of AST/ALT (De Ritis) ratio with sarcopenia in a Chinese population of community-dwelling elderly

Wu,

Wang,

Zhou

et al. 2023

Heliyon

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Association Between Aspartate Aminotransferase to Alanine Aminotransferase Ratio and Incidence of Type 2 Diabetes Mellitus in the Japanese Population: A Secondary Analysis of a Retrospective Cohort Study

Cited by 10 publications

References 45 publications

Low aspartate aminotransferase/alanine aminotransferase (DeRitis) ratio assists in predicting diabetes in Chinese population

Low aspartate aminotransferase/alanine aminotransferase (DeRitis) ratio assists in predicting diabetes in Chinese population

AST-to-ALT ratio in the first trimester and the risk of gestational diabetes mellitus

Association of AST/ALT (De Ritis) ratio with sarcopenia in a Chinese population of community-dwelling elderly

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