Changes Over Time in Hepatic Markers Predict Changes in Insulin Sensitivity, β-Cell Function, and Glycemia

Area of Science:

• Endocrinology
• Metabolic Health
• Hepatology

Background:

• Serum liver enzymes and fetuin-A are linked to type 2 diabetes risk.
• Their longitudinal impact on insulin resistance and beta-cell dysfunction remains unclear.

Purpose of the Study:

• To assess how changes in fetuin-A and liver enzymes (ALT, AST, GGT) over 2 years affect insulin sensitivity, beta-cell function, and glycemia.
• To evaluate these effects in women with prior gestational dysglycemia, representing varied future diabetes risk.

Main Methods:

• 336 women with varying gestational glucose tolerance were assessed postpartum at 1 and 3 years.
• Tests included oral glucose tolerance tests (OGTT) and measurements of ALT, AST, GGT, and fetuin-A.

Main Results:

• Higher baseline ALT/AST ratio and fetuin-A, and their changes over time, predicted lower insulin sensitivity at 3 years.
• Changes in ALT/AST ratio predicted poorer beta-cell function and higher fasting glucose.
• Baseline fetuin-A predicted prediabetes/diabetes at 3 years.

Conclusions:

• Hepatic markers like ALT/AST ratio and fetuin-A correlate with changes in insulin sensitivity and beta-cell function.
• These markers show pathophysiological relevance in predicting diabetic risk.