Abnormal Liver Function Test Predicts Type 2 Diabetes
A community-based prospective study
- Nam H. Cho, MD, PHD1,
- Hak C. Jang, MD2,
- Sung Hee Choi, MD2,
- Hyung R. Kim, MD3,
- Hong Kyu Lee, MD2,
- Juliana C.N. Chan, MD4 and
- Soo Lim, MD2
- 1Preventive Medicine, Ajou University, Suwon, Korea
- 2Internal Medicine, Seoul National University, Seoul, Korea
- 3Korean National Genome Institute, Korean Center for Disease Control and Prevention, Seoul, Korea
- 4Therapeutics, Chinese University of Hong Kong, Hong Kong, China
- Address correspondence and reprint requests to Soo Lim, MD, PHD, Internal Medicine, Seoul National University, 300, Gumi-dong, Bundang-gu, Seongnam-city, South Korea. E-mail: limsoo{at}snu.ac.kr
- ALT, alanine aminotransferase
- AST, aspartate aminotransferase
- GGT, γ-glutamyltranspeptidase
- HOMA-β, homeostasis model assessment of pancreatic β-cell function
- HOMA-IR, homeostastis model assessment of insulin resistance
- QUICKI, quantitative insulin sensitivity check index
Increased activities of liver enzymes such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), and γ-glutamyltranspeptidase (GGT) are indicators of hepatocellular injury. Increased activity of these markers is associated with insulin resistance (1), metabolic syndrome, and type 2 diabetes (2–9). However, most of these studies were performed in Western countries (2–5,7,9), and the two studies from Japan and Korea were not community based (6,8). In this prospective community-based study, we evaluated the relationships between markers of liver function and the onset of type 2 diabetes after adjusting for potential risk factors including inflammatory markers.
RESEARCH DESIGN AND METHODS—
In 2001, the Korean government funded a large community-based epidemiological survey to investigate the trends in diabetes and the associated risk factors (10). For this study, two communities, one from a rural Ansung and the other from an urban Ansan community, were selected. The baseline examination was performed in 2001–2002, and biennial follow-up examinations will continue through 2010. The age range for eligibility was 40–69 years. Of the 7,192 eligible individuals in Ansung, 5,018 were surveyed (70% response rate) using a cluster sampling method. A total of 15,580 individuals were eligible in Ansan, and we successfully recruited 5,020 (32.4%) using a random sampling method of the local telephone directory. The study protocol was approved by the ethics committee of the Korean Health and Genome Study.
Anthropometric parameters and blood pressure were measured by standard methods. Fasting plasma glucose, lipid profiles, insulin, high-sensitivity C-reactive …
