Elevated Liver Function Enzymes Tied to Diabetes Risk

Elevated liver alanine aminotransferase (ALT) and γ-glutamyl transferase (GGT) are potentially useful for predicting the risk of young adults developing diabetes, according to a published study.

Quoc Manh Nguyen, M.D., M.P.H., from Tulane University in New Orleans, and colleagues examined the association and potential predictability of ALT and GGT for the onset of prediabetes and type 2 diabetes in healthy young adults. Cardiometabolic risk factor variables, including ALT and GGT, were measured in 874 adults with normoglycemia, 101 with prediabetes, and 80 with diabetes during a follow-up from young adulthood (average age, 25.1 years) to an average age of 41.3 years.

The investigators found a significantly adverse trend in the prevalence rate of adult diabetes status for both prediabetes and diabetes based on the quartiles of baseline ALT and GGT levels. Individuals with elevated baseline ALT and GGT levels were 1.16 and 1.20 times, respectively, more likely to develop diabetes (P = 0.05 for ALT and P < 0.01 for GGT) in a longitudinal multivariate logistic regression analysis adjusted for anthropometric, hemodynamic, and metabolic variables; alcohol consumption; and smoking. This association was not seen for prediabetes.

The C values obtained from the area under the receiver operating curve analysis for the predictive value of ALT and GGT ranged from 0.70 to 0.82, with values significantly higher for diabetes than prediabetes.

"These findings in younger adults suggest potential clinical utility of including ALT and GGT as biomarkers in diabetes risk assessment formulations," the authors write.

Diabetes Care, Sept 27, 2011