Liver Enzymes and Incident Diabetes: Findings from the European Prospective Investigation into Cancer and Nutrition-Potsdam Study

  1. Earl S. Ford, MD, MPH1,
  2. Matthias B. Schulze, DrPH (mschulze{at}dife.de)2,
  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, USA
  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

    Abstract

    Objective: We sought to examine the association between plasma concentrations of liver enzymes, gamma-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 of the European Prospective Investigation into Cancer and Nutrition-Potsdam Study. The analytic sample included 787 participants with incident diabetes and 2224 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% confidence interval [CI]: 0.66, 1.93), 1.67 (95% CI: 1.01, 2.77), 2.77 (95% CI: 1.71, 4.49), and 2.67 (95% CI: 1.63, 4.37) (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 (95% CI: 0.56, 1.53) for quintile 2, 1.28 (95% CI: 0.83, 1.96) for quintile 3, 1.35 (95% CI: 0.88, 2.07) for quintile 4, and 1.93 (95% CI: 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

      • Received November 11, 2007.
      • Accepted March 11, 2008.

    This Article

    1. Published online before print March 17, 2008, doi: 10.2337/dc07-2159
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