Liver Enzymes Compared With Alcohol Consumption in Predicting the Risk of Type 2 Diabetes
The Kansai Healthcare Study
- Kyoko Kogawa Sato, MD, PHD1,
- Tomoshige Hayashi, MD, PHD1,
- Yoshiko Nakamura, MD, PHD2,
- Nobuko Harita, MD1,
- Takeshi Yoneda, MD1,
- Ginji Endo, MD, PHD1 and
- Hiroshi Kambe, MD2
- 1Department of Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan
- 2Kansai Health Administration Center, Nippon Telegraph and Telephone West Corporation, Osaka, Japan
- Corresponding author: Kyoko Kogawa Sato, MD, PhD, Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan. E-mail: 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 8,576 Japanese men, aged 40–55 years, 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 medications 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 γ-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 ratio 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 were independently associated with the risk of type 2 diabetes. Nondrinkers with the highest GGT or ALT had a high risk of type 2 diabetes.
- ALT, alanine aminotransferase
- AST, aspartate aminotransferase
- FPG, fasting plasma glucose
- GGT, γ-glutamyltransferase
Footnotes
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Published ahead of print at http://care.diabetesjournals.org on 4 March 2008. DOI: 10.2337/dc07-2184.
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.
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- Accepted February 20, 2008.
- Received November 16, 2007.
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