Association between liver enzymes and type 2 diabetes: a real-world study

Area of Science:

• Biochemistry
• Endocrinology
• Public Health

Background:

• Liver enzymes, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl-transferase (GGT), are indicators of liver health.
• Altered liver enzyme levels have been observed in individuals with type 2 diabetes (T2D).
• Understanding the precise relationship between liver enzymes and T2D risk is crucial for early detection and prevention strategies.

Purpose of the Study:

• To investigate the association between ALT, AST, and GGT levels and the risk of developing type 2 diabetes.
• To specifically examine the dose-response relationship between these liver enzymes and T2D risk.
• To assess the generalizability of these associations across different populations.

Main Methods:

• A cross-sectional study was conducted with participants over 20 years old.
• Generalized additive models (GAM) were used to analyze the dose-response relationship between liver enzymes and T2D risk.
• Data from the UK Biobank and NHANES were analyzed to evaluate population differences.

Main Results:

• A significant non-linear relationship was found between liver enzymes and T2D risk (P<0.001).
• T2D risk increased with rising ALT and GGT levels up to 50 IU/L, then plateaued.
• Elevated AST below 35 IU/L showed a protective effect, while levels above 35 IU/L increased T2D risk.

Conclusions:

• Liver enzymes exhibit a non-linear association with T2D risk across diverse populations (China, UK, US).
• Specific elevations in ALT and GGT are linked to increased T2D risk, warranting attention for early intervention.
• Further research is needed to elucidate the mechanisms underlying the non-linear relationship between liver enzymes and T2D.