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Diabetes Care Publish Ahead of Print published online ahead of print March 3, 2008
DOI: 10.2337/dc07-2184
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Original Research

Liver enzymes as compared with alcohol consumption in predicting the risk of type 2 diabetes: The Kansai Healthcare Study

Kyoko Kogawa Sato, M.D., PhD., Tomoshige Hayashi, M.D., PhD., Yoshiko Nakamura, M.D., PhD., Nobuko Harita, M.D., Takeshi Yoneda, M.D., Ginji Endo, M.D., PhD. and Hiroshi Kambe, M.D

1Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan (K.K.S., T.H., N.H., T.Y., G.E.) and Kansai Health Administration Center, Nippon Telegraph and Telephone West Corporation, (Y.N., H.K.)

ksato{at}med.osaka-cu.ac.jp

ABSTRACT

Objective: It has been reported that moderate alcohol consumption decreased the risk of type 2 diabetes but that elevated liver enzymes increased it. The comparative importance of alcohol consumption and liver enzymes as predictors of type 2 diabetes remains unconfirmed.

Research Design and Methods: The participants included 8576 Japanese men, 40-55 years of age, without type 2 diabetes at entry. Type 2 diabetes was diagnosed if a fasting plasma glucose level was ≥126 mg/dL or if participants were taking oral hypoglycemic medication or insulin.

Results: During the 4-year follow-up period, we confirmed 878 cases. In multivariate models, moderate daily alcohol consumption (16.4–42.6 g ethanol/day) decreased the risk of type 2 diabetes, and higher levels of {gamma}-glutamyltransferase (GGT) and alanine aminotransferase (ALT) increased the risk. In joint analyses of alcohol consumption and liver enzymes, moderate drinkers with the lowest tertile of GGT had the lowest risk of type 2 diabetes. Compared with them, nondrinkers with the highest GGT had the highest risk of type 2 diabetes (odds ratios 3.18 (95% CI, 1.75–5.76)). At every level of GGT, moderate or heavy alcohol drinkers (≥42.7 g ethanol/day) had a lower risk of type 2 diabetes than nondrinkers. The relationship of ALT and daily alcohol consumption with the risk of type 2 diabetes was almost the same as that of GGT.

Conclusions: GGT, ALT, and daily alcohol consumption was independently associated with the risk of type 2 diabetes. Nondrinkers with the highest GGT or ALT had a high risk of type 2 diabetes.


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