Liver enzymes, race, gender and diabetes risk: the Atherosclerosis Risk in Communities (ARIC) Study.
Liver enzymes, race, gender and diabetes risk: the Atherosclerosis Risk in Communities (ARIC) Study.
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DOI：
10.1111/dme.12187
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发表时间：
2013-08
期刊：
影响因子：
--
通讯作者：
Selvin E
中科院分区：
文献类型：
--
作者：
Schneider AL;Lazo M;Ndumele CE;Pankow JS;Coresh J;Clark JM;Selvin E
研究肝酶丙氨酸氨基转移酶、天冬氨酸氨基转移酶和γ-谷氨酰转移酶与糖尿病风险的关系，并确定这种关系是否因种族和/或性别而异。我们假设所有肝酶都与糖尿病风险相关，并且这种相关性因种族和性别而异。社区动脉粥样硬化风险研究中7495名白色和1842名非糖尿病黑人参与者的前瞻性队列。采用Poisson和考克斯模型，根据人口统计学、社会行为、代谢和健康相关因素进行调整。在平均12年的随访中，发生了2182例糖尿病事件。较高的肝酶水平与糖尿病风险独立相关：丙氨酸氨基转移酶、天冬氨酸氨基转移酶（AST）和γ-谷氨酰转移酶（GGT）的最高和最低四分位数的校正风险比（95%置信区间）分别为1.68（1.49-1.89）、1.16（1.02-1.31）和1.95（1.70-2.24）。γ-谷氨酰转移酶与糖尿病风险的相关性最强，即使在临床实践中认为处于正常范围（≤ 60 U/l）的水平。按肝酶四分位数校正的发病率在不同性别之间相似，但黑人高于白色受试者。尽管如此，丙氨酸氨基转移酶、天冬氨酸氨基转移酶和γ-谷氨酰转移酶（GGT）与糖尿病的相关性在不同种族之间是相似的（相互作用P> 0.05）。与天冬氨酸转氨酶和丙氨酸转氨酶相比，γ-谷氨酰转移酶与糖尿病风险的相关性更强。我们的研究结果表明，肝酶的异常在糖尿病的诊断之前很多年，肝酶升高的个体，即使在临床实践中定义的正常范围内，也有患糖尿病的高风险。
To examine the associations of the liver enzymes alanine aminotransferase, aspartate aminotransferase and gamma-glutamyl transferase with diabetes risk and to determine whether associations differ by race and/or gender. We hypothesized that all liver enzymes would be associated with diabetes risk and that associations would differ by race and gender. Prospective cohort of 7495 white and 1842 black participants without diabetes in the Atherosclerosis Risk in Communities Study. Poisson and Cox models adjusted for demographic, socio-behavioural, and metabolic and health-related factors were used. During a median of 12 years of follow-up, 2182 incident cases of diabetes occurred. Higher liver enzyme levels were independently associated with diabetes risk: adjusted hazard ratios (95% confidence intervals) were 1.68 (1.49–1.89), 1.16 (1.02–1.31) and 1.95 (1.70–2.24) comparing the highest with the lowest quartiles of alanine aminotransferase, aspartate aminotransferase (AST) and gamma-glutamyl transferase (GGT), respectively. gamma-Glutamyl transferase was most strongly related to diabetes risk, even at levels considered within normal range (≤ 60 U/l) in clinical practice. Adjusted incidence rates by quartiles of liver enzymes were similar by gender but higher in black versus white participants. Nonetheless, relative associations of alanine aminotransferase, aspartate aminotransferase, and gamma-glutamyl transferase (GGT) with diabetes were similar by race (P for interactions > 0.05). Compared with aspartate aminotransferase and alanine aminotransferase, gamma-glutamyl transferase was more strongly associated with diabetes risk. Our findings suggest that abnormalities in liver enzymes precede the diagnosis of diabetes by many years and that individuals with elevated liver enzymes, even within the normal range as defined in clinical practice, are at high risk for diabetes.
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DOI：
10.1136/bmj.d6891
发表时间：
2011-11-18
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Lazo M;Hernaez R;Bonekamp S;Kamel IR;Brancati FL;Guallar E;Clark JM
通讯作者：
Clark JM
影响因子：
16.2
作者：
Fraser A;Harris R;Sattar N;Ebrahim S;Davey Smith G;Lawlor DA
通讯作者：
Lawlor DA
影响因子：
5
作者：
Bielinski, Suzette J.;Pankow, James S.;Brancati, Frederick
通讯作者：
Brancati, Frederick
影响因子：
13.5
作者：
Browning, JD;Szczepaniak, LS;Hobbs, HH
通讯作者：
Hobbs, HH
影响因子：
16.2
作者：
Cowie CC;Rust KF;Ford ES;Eberhardt MS;Byrd-Holt DD;Li C;Williams DE;Gregg EW;Bainbridge KE;Saydah SH;Geiss LS
通讯作者：
Geiss LS