Diabetes Care
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Purchase Article
Right arrow View Shopping Cart
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Request Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Wannamethee, S. G.
Right arrow Articles by Whincup, P. H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Wannamethee, S. G.
Right arrow Articles by Whincup, P. H.
Social Bookmarking
Add to CiteULike   Add to Del.icio.us   Add to Digg   Add to Reddit   Add to Technorati  
What's this?
Diabetes Care 28:2913-2918, 2005
© 2005 by the American Diabetes Association, Inc.

Metabolic Syndrome/Insulin Resistance Syndrome/Pre-Diabetes
Original Article

Hepatic Enzymes, the Metabolic Syndrome, and the Risk of Type 2 Diabetes in Older Men

Sasiwarang Goya Wannamethee, PHD1, Andrew Gerald Shaper, FRCP1, Lucy Lennon, MSC1 and Peter H. Whincup, FRCP2

1 Department of Primary Care and Population Sciences, Royal Free and University College Medical School, London, U.K
2 Department of Public Health Sciences, St. George’s Medical School Hospital, London, U.K

Address correspondence and reprint requests to Dr. S. Goya Wannamethee, Department of Primary Care and Population Sciences, Royal Free and University College Medical School, Rowland Hill Street, London NW3 2PF, U.K. E-mail: goya{at}pcps.ucl.ac.uk

OBJECTIVE—We have examined the relationship between hepatic enzymes, the metabolic syndrome, insulin resistance, and type 2 diabetes and assessed the potential of hepatic enzyme measurements in determining diabetes risk.

RESEARCH DESIGN AND METHODS—We conducted a prospective study of 3,500 nondiabetic men aged 60–79 years who were followed-up for a mean period of 5 years and in whom there were 100 incident type 2 diabetes cases.

RESULTS—In cross-sectional analyses, alanine aminotransferase (ALT) and {gamma}-glutamyltransferase (GGT) were strongly associated with obesity, insulin resistance, and the metabolic syndrome. Prospectively, the risk of type 2 diabetes significantly increased with increasing levels of ALT and GGT even after adjustment for confounders including BMI (top versus bottom quarter ALT: relative risk 2.72 [95% CI 1.47–5.02]; GGT: 3.68 [1.68–8.04]). Additional adjustment for insulin resistance attenuated the effects, but the relationships with ALT and GGT remained significant (1.91 [1.01–3.60] and 2.69 [1.21–5.97], respectively). Further adjustment for inflammatory markers (C-reactive protein) made minor differences. Among high-risk subjects (obese men or those with the metabolic syndrome), elevated GGT and ALT enhanced the prediction of diabetes risk.

CONCLUSIONS— Elevated levels of ALT and GGT within the normal range are independent predictors of type 2 diabetes in older men and are useful additional measures in identifying those at high risk of diabetes.

Abbreviations: ALT, alanine aminotransferase • AST, aspartate transaminase • CRP, C-reactive protein • GGT, {gamma}-glutamyltransferase • HOMA-IR, homeostasis model assessment of insulin resistance


Add to CiteULike CiteULike   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 HypertensionHome page
G. Schillaci, G. V.L. De Socio, G. Pucci, M. R. Mannarino, J. Helou, M. Pirro, and E. Mannarino
Aortic Stiffness in Untreated Adult Patients With Human Immunodeficiency Virus Infection
Hypertension, August 1, 2008; 52(2): 308 - 313.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Clin. Nutr.Home page
H. R. Song, K. E. Yun, and H. S. Park
Relation between alanine aminotransferase concentrations and visceral fat accumulation among nondiabetic overweight Korean women
Am. J. Clinical Nutrition, July 1, 2008; 88(1): 16 - 21.
[Abstract] [Full Text] [PDF]

Home page
 Diabetes CareHome page
K. K. Sato, T. Hayashi, Y. Nakamura, N. Harita, T. Yoneda, G. Endo, and H. Kambe
Liver Enzymes Compared With Alcohol Consumption in Predicting the Risk of Type 2 Diabetes: The Kansai Healthcare Study
Diabetes Care, June 1, 2008; 31(6): 1230 - 1236.
[Abstract] [Full Text] [PDF]

Home page
 Diabetes CareHome page
E. S. Ford, M. B. Schulze, M. M. Bergmann, C. Thamer, H.-G. Joost, and H. Boeing
Liver Enzymes and Incident Diabetes: Findings from the European Prospective Investigation Into Cancer and Nutrition (EPIC)-Potsdam Study
Diabetes Care, June 1, 2008; 31(6): 1138 - 1143.
[Abstract] [Full Text] [PDF]

Home page
 Diabetes CareHome page
S. G. Wannamethee, N. Sattar, A. Rumley, P. H. Whincup, L. Lennon, and G. D.O. Lowe
Tissue Plasminogen Activator, von Willebrand Factor, and Risk of Type 2 Diabetes in Older Men
Diabetes Care, May 1, 2008; 31(5): 995 - 1000.
[Abstract] [Full Text] [PDF]

Home page
 Arterioscler. Thromb. Vasc. Bio.Home page
A. Fraser, R. Harris, N. Sattar, S. Ebrahim, G. D. Smith, and D.A. Lawlor
Gamma-Glutamyltransferase Is Associated With Incident Vascular Events Independently of Alcohol Intake: Analysis of the British Women's Heart and Health Study and Meta-Analysis
Arterioscler. Thromb. Vasc. Biol., December 1, 2007; 27(12): 2729 - 2735.
[Abstract] [Full Text] [PDF]

Home page
 Diabetes CareHome page
N. H. Cho, H. C. Jang, S. H. Choi, H. R. Kim, H. K. Lee, J. C.N. Chan, and S. Lim
Abnormal Liver Function Test Predicts Type 2 Diabetes: A community-based prospective study
Diabetes Care, October 1, 2007; 30(10): 2566 - 2568.
[Full Text] [PDF]

Home page
 Diabetes CareHome page
P. Andre, B. Balkau, S. Vol, M. A. Charles, E. Eschwege, and on behalf of the DESIR Study Group
{gamma}-Glutamyltransferase Activity and Development of the Metabolic Syndrome (International Diabetes Federation Definition) in Middle-Aged Men and Women: Data From the Epidemiological Study on the Insulin Resistance Syndrome (DESIR) cohort
Diabetes Care, September 1, 2007; 30(9): 2355 - 2361.
[Abstract] [Full Text] [PDF]

Home page
 Diabetes CareHome page
A. J.G. Hanley, L. E. Wagenknecht, A. Festa, R. B. D'Agostino Jr., and S. M. Haffner
Alanine Aminotransferase and Directly Measured Insulin Sensitivity in a Multiethnic Cohort: The Insulin Resistance Atherosclerosis Study
Diabetes Care, July 1, 2007; 30(7): 1819 - 1827.
[Abstract] [Full Text] [PDF]

Home page
 DiabetesHome page
N. Sattar, A. McConnachie, I. Ford, A. Gaw, S. J. Cleland, N. G. Forouhi, P. McFarlane, J. Shepherd, S. Cobbe, and C. Packard
Serial Metabolic Measurements and Conversion to Type 2 Diabetes in the West of Scotland Coronary Prevention Study: Specific Elevations in Alanine Aminotransferase and Triglycerides Suggest Hepatic Fat Accumulation as a Potential Contributing Factor
Diabetes, April 1, 2007; 56(4): 984 - 991.
[Abstract] [Full Text] [PDF]

Home page
 Clin. Chem.Home page
Y. Chang, S. Ryu, E. Sung, and Y. Jang
Higher Concentrations of Alanine Aminotransferase within the Reference Interval Predict Nonalcoholic Fatty Liver Disease
Clin. Chem., April 1, 2007; 53(4): 686 - 692.
[Abstract] [Full Text] [PDF]

Home page
 Arterioscler. Thromb. Vasc. Bio.Home page
S. M. Grundy
Gamma-Glutamyl Transferase: Another Biomarker for Metabolic Syndrome and Cardiovascular Risk
Arterioscler. Thromb. Vasc. Biol., January 1, 2007; 27(1): 4 - 7.
[Full Text] [PDF]

Home page
 Clin. Chem.Home page
J. B. Whitfield
Serum {gamma}-Glutamyltransferase and Risk of Disease
Clin. Chem., January 1, 2007; 53(1): 1 - 2.
[Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Diabetes Diabetes Care Clinical Diabetes Diabetes Spectrum
Copyright © 2005 by the American Diabetes Association.