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

Lakmini Pinnaduwage¹, Chang Ye¹, Anthony J Hanley^1,2,3

¹Leadership Sinai Centre for Diabetes, Mount Sinai Hospital, Toronto, Ontario, Canada.

The Journal of Clinical Endocrinology and Metabolism

|June 14, 2018

Summary

Changes in liver enzymes (ALT/AST ratio) and fetuin-A over time predict future insulin resistance and beta-cell dysfunction in women with prior gestational dysglycemia, indicating diabetic risk.

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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.