The Association of Aspartate Aminotransferase/Alanine Aminotransferase Ratio with Diabetic Nephropathy in Patients with Type 2 Diabetes

Abstract

Purpose: To investigate the relationship between aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT) and diabetic nephropathy (DN). Patients and Methods: A total of 402 patients with type 2 diabetes mellitus were divided into three groups, such as normoalbuminuria (n = 196), microalbuminuria (n = 131) and macroalbuminuria (n = 75) groups. Basic information and laboratory results were collected. Serum AST/ALT, tumor necrosis factor-α (TNF-α), interleukin (IL)-2, IL-4, IL-6, IL-10 and interferon-γ (INF-γ) were also measured. DN was defined as microalbuminuria or macroalbuminuria. The estimated glomerular filtration rate (eGFR) was calculated using the following formula: 186 × (serum creatinine) −1.154 × (age) −0.203 × (0.742 if female). Results: The AST/ALT in the macroalbuminuria group was higher than in the microalbuminuria and normoalbuminuria groups. The concentrations of tumor necrosis factor-α (TNFα), IL-2, IL-4, IL-10 and INF-γ in the macroalbuminuria group were significantly higher than those in the two other groups. Multivariate logistical analysis showed that after adjusting confounding factors, TNF-α and high AST/ALT were independent risks for DN and macroalbuminuria. Furthermore, the AST/ALT had significantly positive correlation with TNF-α (r = 0.101, P = 0.048), IL-4 (r = 0.185, P = 0.005) and IL-6 (r = 0.274, P < 0.001) levels. Conclusion:This study showed that high AST/ALT was an independent risk factor for the DN. Additionally, AST/ALT was positively correlated with inflammation cytokines, such as TNF-α, IL-4 and IL-6 levels.

Biomarkers of Response to Low-Dose Aspirin in Familial Adenomatous Polyposis Patients

“…Our findings may implicate enhanced systemic inflammation in FAP patients with a higher AST/ALT ratio. Xu et al have reported that AST/ALT ratio was positively correlated with circulating inflammatory cytokines, such as TNF-α, IL-4, and IL-6, in type 2 diabetes mellitus patients [49]. In the present study, FAP patients with a higher AST/ALT ratio showed a higher count of blood leukocytes (mainly neutrophils and lymphocytes).…”

Association Between Serum Albumin Level and Microvascular Complications of Type 2 Diabetes Mellitus

“…29,30 In addition, patients with low sALB are also accompanied by high SBP and low levels of ALT, which may also be the reason for the higher incidence of DKD and DR in patients with low sALB. Studies have shown that hypertension and ALT are related to the incidence of DKD and DR. [31][32][33] Therefore, patients with T2DM with lower sALB levels must be screened for DR or DKD. Combined with our subgroup analysis results, DR screening should pay special attention to men aged <65 years, whereas DKD screening should pay attention to people <65 years old.…”

The Clinical Significance of Urinary Retinol-Binding Protein 4: A Review

“…T2DM is a progressive disorder associated with a number of micro- and macrovascular complications. The most common, long-term microvascular consequence of T2DM (diagnosed in ~50% of patients) includes diabetic kidney disease (DKD, formerly diabetic nephropathy, DN), which tends to progress to CKD and eventually to ESRD (in around 30–45% of DKD patients) [ 13 , 62 , 63 ]. The “gold standard” for the early diagnosis of DKD is microalbuminuria, which is, however, not ideal due to limited diagnostic accuracy.…”