Liver Enzymes and Incident Diabetes

Findings from the European Prospective Investigation Into Cancer and Nutrition (EPIC)-Potsdam Study

  1. Earl S. Ford, MD, MPH1,
  2. Matthias B. Schulze, DRPH2,
  3. Manuela M. Bergmann, PHD2,
  4. Claus Thamer, MD3,
  5. Hans-Georg Joost, MD, PHD4 and
  6. Heiner Boeing, PHD2
  1. 1Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
  2. 2Department of Epidemiology, German Institute for Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
  3. 3Internal Medicine Department IV, University of Tübingen, Tübingen, Germany
  4. 4Department of Pharmacology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
  1. Corresponding author: Matthias B. Schulze, DrPH, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-115, 14558 Nuthetal, Germany. E-mail: mschulze{at}dife.de

Abstract

OBJECTIVE—We sought to examine the association between plasma concentrations of liver enzymes γ-glutamyltransferase (GGT) and alanine transaminase (ALT) and incident diabetes, prospectively.

RESEARCH DESIGN AND METHODS—We conducted a case-cohort analysis of data from participants mainly aged 35–65 years in the European Prospective Investigation into Cancer and Nutrition–Potsdam Study. The analytic sample included 787 participants with incident diabetes and 2,224 participants without diabetes.

RESULTS—Concentrations of GGT and ALT were significantly associated with incident diabetes after extensive adjustment. Compared with participants in the lowest quintile of GGT, the adjusted hazard ratios for increasing quintiles were 1.13 (95% CI 0.66–1.93), 1.67 (1.01–2.77), 2.77 (1.71–4.49), and 2.67 (1.63–4.37), respectively (P for linear trend <0.001). Compared with participants in the lowest quintile of ALT, the adjusted hazard ratios for incident diabetes were 0.93 (0.56–1.53) for quintile 2, 1.28 (0.83–1.96) for quintile 3, 1.35 (0.88–2.07) for quintile 4, and 1.93 (1.27–2.92) for quintile 5 (P for linear trend = 0.002). The magnitude of the associations were higher among men than women for GGT (P = 0.004) but did not differ significantly between men and women for ALT (P = 0.307).

CONCLUSIONS—Concentrations of GGT and ALT were significant predictors of incident diabetes in this study, even at concentrations still considered to be within the normal range.

Footnotes

  • Published ahead of print at http://care.diabetesjournals.org on 17 March 2008. DOI: 10.2337/dc07-2159.

    The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked “advertisement” in accordance with 18 U.S.C Section 1734 solely to indicate this fact.

    • Accepted March 11, 2008.
    • Received November 11, 2007.
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  1. Published online before print March 17, 2008, doi: 10.2337/dc07-2159 Diabetes Care June 2008 vol. 31 no. 6 1138-1143
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