Table 2—

The risk of incidence of the metabolic syndrome among 2,957 metabolic syndrome-free Japanese men during 7 years of follow-up in relation to serum liver enzyme levels

OutcomeLiver enzyme
P for trend
Quintile 1Quintile 2Quintile 3Quintile 4Quintile 5
GGT (units/l)<14 (n = 526)14–19 (n = 602)20–28 (n = 638)29–48 (n = 594)≥49 (n = 597)
 Cases/person-years42/3,23596/3,557118/3,669161/3,213191/3,085
 Incidence density (per 1,000 person-years)13.027.032.250.161.9
 Adjusted relative risk (95% CI)
  Model 1*1.0 (referent)2.05 (1.43–2.95)2.44 (1.72–3.47)3.74 (2.66–5.25)4.56 (3.26–6.37)<0.001
  Model 21.0 (referent)1.49 (1.03–2.15)1.55 (1.08–2.22)2.28 (1.61–3.25)2.92 (2.05–4.17)<0.001
  Model 31.0 (referent)1.37 (0.95–1.98)1.35 (0.93–1.95)1.91 (1.31–2.77)2.23 (1.51–3.30)<0.001
ALT (units/l)<14 (n = 560)14–16 (n = 457)17–21 (n = 692)22–28 (n = 631)≥29 (n = 617)
 Cases/person-years59/3,38454/2,704116/4,014160/3,491219/3,165
 Incidence density (per 1,000 person-years)17.420.028.945.869.2
 Adjusted relative risk (95% CI)
  Model 1*1.0 (referent)1.13 (0.78–1.63)1.63 (1.19–2.23)2.58 (1.91–3.47)3.87 (2.90–5.16)<0.001
  Model 21.0 (referent)0.99 (0.68–1.43)1.25 (0.91–1.71)1.64 (1.21–2.22)2.06 (1.54–2.77)<0.001
  Model 31.0 (referent)0.89 (0.61–1.30)1.07 (0.76–1.49)1.27 (0.89–1.80)1.42 (0.95–2.11)0.093
AST (units/l)<17 (n = 511)17–18 (n = 455)19–21 (n = 743)22–25 (n = 624)≥26 (n = 624)
 Cases/person-years68/3,07074/2,664129/4,332159/3,370178/3,322
 Incidence density (per 1,000 person-years)22.127.829.847.253.6
 Adjusted relative risk (95% CI)
  Model 1*1.0 (referent)1.24 (0.90–1.73)1.33 (0.99–1.79)2.07 (1.56–2.75)2.34 (1.77–3.10)<0.001
  Model 21.0 (referent)1.18 (0.84–1.63)1.12 (0.83–1.50)1.70 (1.27–2.27)1.75 (1.32–2.32)<0.001
  Model 31.0 (referent)1.00 (0.71–1.40)0.85 (0.62–1.17)1.04 (0.73–1.48)0.92 (0.63–1.34)0.774
Alkaline phosphatase (units/l)<140 (n = 583)140–155 (n = 586)156–170 (n = 590)171–191 (n = 578)≥192 (n = 620)
 Cases/person-years84/3,433121/3,334122/3,348131/3,225150/3,419
 Incidence density (per 1,000 person-years)24.536.336.440.643.9
 Adjusted relative risk (95% CI)
  Model 1*1.0 (referent)1.47 (1.11–1.94)1.48 (1.12–1.96)1.64 (1.25–2.16)1.76 (1.35–2.30)<0.001
  Model 21.0 (referent)1.40 (1.06–1.86)1.44 (1.09–1.90)1.82 (1.38–2.40)1.66 (1.27–2.18)<0.001
  Model 31.0 (referent)1.39 (1.05–1.84)1.41 (1.06–1.86)1.73 (1.31–2.28)1.49 (1.13–1.95)0.003
  • *

    * Model 1: adjustment for age;

  • model 2: model 1 plus adjustment for family history of diabetes, BMI, alcohol intake, cigarette smoking, regular physical activity, and WBC count;

  • model 3: model 2 plus adjustment for all of the other liver enzymes.