The association of plasma levels of liver enzymes and risk of gestational diabetes mellitus: a systematic review and dose–response meta-analysis of observational studies

Zhao, Wei; Zhang, Li; Zhang, Guoliang; Varkaneh, Hamed Kord; Rahmani, Jamal; Clark, Cain C. T.; Ryan, Paul M.; Abdulazeem, Hebatullah Mohamed; Salehi‐Sahlabadi, Ammar

doi:10.1007/s00592-019-01458-8

Cited by 19 publications

(24 citation statements)

References 54 publications

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“…Complement C4 was also elevated in GDM and associated with CRP as a marker of inflammation but, in the regression model accounting for CRP, ALT and SBP, then C4 was no longer significant, mirroring the findings with C3. ALT levels were higher in GDM, but not above the upper limit of the reference range; however, alterations in ALT are associated with non-alcoholic fatty liver disease which features an increase in insulin resistance, and an elevated ALT is associated with increased risk for GDM ( 36 ) though, notably, gamma-glutamyl transferase is a superior predictor of GDM ( 37 ). The correlation of C4 with ALT in GDM has not previously been reported.…”

Section: Discussionmentioning

confidence: 99%

Association of Complement-Related Proteins in Subjects With and Without Second Trimester Gestational Diabetes

et al. 2021

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IntroductionGestational Diabetes Mellitus (GDM) development is related to underlying metabolic syndrome that is associated with elevated complement C3 and C4. Elevated C3 levels have been associated with preeclampsia and the development of macrosomia.MethodsThis case-control study included 34 pregnant women with GDM and 16 non-diabetic (ND) women in their second trimester. Complement-related proteins were measured and correlated with demographic, biochemical, and pregnancy outcome data.ResultsGDM women were older with a higher BMI (p<0.001); complement C3, C4 and Factor-H were significantly elevated (p=0.001, p=0.05, p=0.01, respectively). When adjusted for age and BMI, Complement C3 (p=0.04) and Factor-H (p=0.04) remained significant. Partial correlation showed significant correlation between C4 with serum alanine aminotransferase (ALT) (p<0.05) and 2nd term diastolic blood pressure (p<0.05); Factor-H and C-reactive protein (CRP; p<0.05). Pearson bivariate analysis revealed significant correlations between C3, C4, and Factor-H and CRP; p<0.05; C3 and gestational age at delivery (GA; p<0.05); C4 and ALT and second-trimester systolic blood pressure (STBP) (p=0.008 and p<0.05, respectively); Factor-H and glycated hemoglobin (HbA1c) (p<0.05). Regression analysis showed that the elevation of C3 could be accounted for by age, BMI, GA and CRP, with CRP being the most important predictor (p=0.02). C4 elevation could be accounted for by ALT, CRP and STBP. CRP predicted Factor-H elevation.ConclusionThe increased C3, C4 and Factor-H during the second trimester of pregnancy in GDM are not independently associated with GDM; inflammation and high BMI may be responsible for their elevation. The elevation of second trimester C3 in GDM is associated with earlier delivery and further work is needed to determine if this is predictive.

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Section: Discussionmentioning

confidence: 99%

Association of Complement-Related Proteins in Subjects With and Without Second Trimester Gestational Diabetes

et al. 2021

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“…AST was similar to ALT and ALP, but AST presented as a protective factor in the male ≥ 7.0 mmol/L group, when the adjacent blood glucose groups were successively changed to controls, which may re ect AST as not being linearly correlated with the risk of elevated blood glucose in men, and suggests that AST may not be suitable for predicting T2DM. Others have also proposed a lack of correlation between AST and T2DM [12,13] . However, AST behaved differently in women when compared to men and it may therefore, play a role in the prediction of T2DM in women.…”

Section: Discussionmentioning

confidence: 99%

Potential role of liver enzymes for predicting elevated blood glucose levels

Nian

Feng

et al. 2021

Preprint

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Background This study was to explore the potential effect of different liver enzymes on elevated blood glucose with the use of a more detailed blood glucose grouping. Methods This cross-sectional study enrolled 144,135 participants who had biochemical examinations from 2014–2018. Participants were classified by sex and different blood glucose levels (< 5.0 mmol/L, 5.0-5.5 mmol/L, 5.6–6.2 mmol/L, 6.3–6.9 mmol/L, and ≥ 7.0 mmol/L). The associations between liver function indicators and occurrence of type 2 diabetes (T2DM) were analyzed through multivariate linear regression and multiple logistic regression. Results There was a significant difference among the biochemical indices between different blood glucose groups in males and females. Liver enzymes such as alanine aminotransferase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), and γ-glutamyl transpeptidase (GGT) were independent risk factors for raised blood glucose, and there were gender differences in the predictive performance of each liver enzyme to elevated blood glucose levels. In men, GGT was the most appropriate to predict progressive elevation of blood glucose or T2DM risk, and ALT and ALP may only be applicable to the prediction of impaired fasting glucose (IFG). By contrast, ALT and ALP were the most appropriate enzymes for the prediction of the risk of elevated blood glucose or T2DM in women, and AST and GGT may only be appropriate for the prediction of IFG. Conclusions Liver enzymes were independent risk factors for elevated blood glucose. There were gender differences in the role of each liver enzyme for elevated blood glucose. GGT was more suitable as a predictor for dynastic elevated blood glucose in men, whereas for women, ALT and ALP were more suitable.

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“…Lee [118], Zhao [119] Elevated liver enzymes Possible marker of insulin resistance and metabolic syndrome…”

Section: Abnormality In Liver Function Significance Referencesmentioning

confidence: 99%

Hepatocrinology

2021

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Hepatocrinology is defined as a bidirectional, complex relationship between hepatic physiology and endocrine function, hepatic disease and endocrine dysfunction, hepatotropic drugs and endocrine function, and endocrine drugs and hepatic health. The scope of hepatocrinology includes conditions of varied etiology (metabolic, infectious, autoimmune, and invasive) that we term as hepato-endocrine syndromes. This perspective shares the definition, concept, and scope of hepatocrinology and shares insight related to this aspect of medicine. It is hoped that this communication will encourage further attention and research in this critical field.

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The association of plasma levels of liver enzymes and risk of gestational diabetes mellitus: a systematic review and dose–response meta-analysis of observational studies

Cited by 19 publications

References 54 publications

Association of Complement-Related Proteins in Subjects With and Without Second Trimester Gestational Diabetes

Association of Complement-Related Proteins in Subjects With and Without Second Trimester Gestational Diabetes

Potential role of liver enzymes for predicting elevated blood glucose levels

Hepatocrinology

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