Serum liver enzymes and diabetes from the Rafsanjan cohort study

Abstract

Background We evaluated the relation between ALT, AST, GGT and ALP with diabetes in the Rafsanjan Cohort Study. Materials and methods The present study is a cross-sectional research including 9991 adults participated via sampling. We used data obtained from the Rafsanjan Cohort Study (RCS), as a part of the prospective epidemiological research studies in IrAN (PERSIAN). Elevated serum levels of ALT, AST, GGT and ALP were defined according to the reference range of the laboratory in the cohort center. Serum liver enzymes levels within the normal range were categorized into quartiles, and their relationship with diabetes was evaluated by logistic regressions. Findings In present study, elevated serum levels of ALT, AST, GGT, and ALP were associated with increased odds of diabetes (adjusted ORs: 1.81, 95%CI 1.51–2.17; 1.75, 95%CI 1.32–2.32; 1.77, 95%CI 1.50–2.08; 1.60, 95%CI 1.35–1.90 respectively). Also, in subjects with normal levels of ALT, GGT and ALP, a dose–response increase was shown for diabetes. Conclusion Elevated levels of ALT, AST, GGT and ALP are related to a higher odds of diabetes. Also, increased levels of ALT, GGT and ALP even within normal range were independently related with the increased odds of diabetes. These results indicated the potential of elevated liver enzymes as biomarkers for the possible presence of diabetes.

The Frequency of Abnormally High Liver Enzymes and their Connection to Type 2 Diabetes Mellitus

“…These findings were comparable to the previous studies. [22,23] As much as 71.2% of the general population and 70.0% of the T2DM population in previous study have abnormal LFTs. [24].…”

Prevalence and metabolic determinants of abnormal alanine aminotransferase: A cross‐sectional study of Iranian adults, 2018–2022

“…With increasing age, the prevalence of abnormal ALT declines significantly among the Tehranian population, an issue that was addressed in previous studies 9,42,46 . As reported by Mahady et.al, 42 each decade increase in age decreases the odds of elevated ALT by 29% among Australians, while this was reported to be 18% in the Dutch population 45 .…”

“…In the previous nested case–control study in TLGS, Tohidi et.al 49 showed that among liver enzymes, only ALT was significantly associated with T2DM even after adjustment with classic risk factors[3.18 (1.02–9.86)]. In another study, a dose–response increase was reported for ALT and T2DM 9 . However, in our study, both genders showed a significant association between high FPG and abnormal ALT, but most of the studies reported this association only among women 44,50,51 .…”

“…Also, there is a similar growing trend for the prevalence of elevated ALT in the Korean population; from 7.4% (>43 U/L) in 2009, to 7.8% (>40 U/L) in 2015 7,8 . In a cross‐sectional study in the southeast of the Kerman province of Iran‐2017, the prevalence of elevated ALT (> 40 U/L in males and >35 U/L in females) was 6.7% in females and 11.7% in males, and it was more prevalent among younger individuals 9 . In another study conducted in the north‐east of Iran‐2013, the prevalence of elevated ALT (> 40 U/L for both males and females) among individuals aged >50 years was 4% (4.9% in males and 3.5% in females) and more frequent among the younger population 10 .…”

Investigating the relationship between liver enzymes and incidence of hypertension: A population‐based cohort study in Kharameh, a city in the South of Iran

“…The quartiles for GGT levels in men were: ≤18 U/L, 19–23 U/L, 24–31 U/L, and 32–54 U/L, while for women the quartiles were: ≤14 U/L, 15–18 U/L, 19–23 U/L, and 24–37 U/L. The quartiles for ALP levels in both genders included: ≤177 U/L, 178–209 U/L, 210–244 U/L, and 245–306 U/L 22 …”