PMID- 29936075 OWN - NLM STAT- MEDLINE DCOM- 20190325 LR - 20190325 IS - 2352-3840 (Electronic) IS - 1499-2671 (Linking) VI - 42 IP - 6 DP - 2018 Dec TI - Liver Enzymes, Fatty Liver and Type 2 Diabetes Mellitus in a Jinchang Cohort: A Prospective Study in Adults. PG - 652-658 LID - S1499-2671(17)30342-8 [pii] LID - 10.1016/j.jcjd.2018.02.002 [doi] AB - OBJECTIVES: It is unclear whether liver enzymes or the interactions of various liver enzymes is a predictor of type 2 diabetes mellitus (T2DM), which is independent of fatty liver. METHODS: A total of 48,001 subjects participated in baseline examinations. Among the subjects, 33,355 were followed for an average of 2.2 years. Cox proportional hazard models were used to examine the adjusted associations of AST, GGT and ALT with T2DM. RESULTS: The cumulative incidence of T2DM was 8.05% to 9.02% for fatty liver and 2.25% to 4.10% for non-fatty liver, both showing statistically significant differences. Compared with the normal liver enzyme levels in the group with fatty liver, the adjusted incident hazard ratios in T2DM were: ALT 1.23 (95% CI 1.10 to 1.50); AST 1.30 (95% CI 1.07-1.59); and GGT 1.34 (95% CI 1.08 to 1.65). In addition, compared with the normal liver enzyme levels in the group with non-fatty liver, the adjusted incident hazard ratios in type 2 diabetes were: ALT 1.27 (95% CI 1.02 to 1.59); AST 1.33 (95% CI 1.02 to 1.59); and GGT 1.53 (95% CI 1.19 to 1.98). There are significant interactions of T2DM hazard ratios between GGT and ALT and between GGT and AST in addition to ALT and AST. CONCLUSIONS: Our results suggest that the incidence of T2DM in the group with fatty liver is significantly higher than that in the normal population, and the rise of serum AST, GGT and ALT levels are risk factors independent of fatty liver for the development of T2DM after adjusting for confounding factors. CI - Copyright (c) 2018 Diabetes Canada. Published by Elsevier Inc. All rights reserved. FAU - Zhang, Jianping AU - Zhang J AD - Key Laboratory of Preclinical Study for New Drugs of Gansu Province, Basic Medical College, Lanzhou University, Lanzhou, Gansu, People's Republic of China; Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, People's Republic of China. FAU - Cheng, Ning AU - Cheng N AD - Key Laboratory of Preclinical Study for New Drugs of Gansu Province, Basic Medical College, Lanzhou University, Lanzhou, Gansu, People's Republic of China. Electronic address: chengn@lzu.edu.cn. FAU - Ma, Yubao AU - Ma Y AD - Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, People's Republic of China. FAU - Li, Haiyan AU - Li H AD - Workers' Hospital of Jinchuan Group Co., Ltd., Jinchang, Gansu, People's Republic of China. FAU - Cheng, Zhiyuan AU - Cheng Z AD - Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, People's Republic of China. FAU - Yang, Yanxu AU - Yang Y AD - Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, People's Republic of China. FAU - He, Caili AU - He C AD - Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, People's Republic of China. FAU - Li, Juansheng AU - Li J AD - Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, People's Republic of China. FAU - Pu, Hongquan AU - Pu H AD - Workers' Hospital of Jinchuan Group Co., Ltd., Jinchang, Gansu, People's Republic of China. FAU - Shen, Xiping AU - Shen X AD - Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, People's Republic of China. FAU - Ren, Xiaoyu AU - Ren X AD - Key Laboratory of Preclinical Study for New Drugs of Gansu Province, Basic Medical College, Lanzhou University, Lanzhou, Gansu, People's Republic of China; Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, People's Republic of China. FAU - Shi, Dian AU - Shi D AD - Key Laboratory of Preclinical Study for New Drugs of Gansu Province, Basic Medical College, Lanzhou University, Lanzhou, Gansu, People's Republic of China. FAU - Pu, Ruiyang AU - Pu R AD - Key Laboratory of Preclinical Study for New Drugs of Gansu Province, Basic Medical College, Lanzhou University, Lanzhou, Gansu, People's Republic of China. FAU - Gan, Ting AU - Gan T AD - Key Laboratory of Preclinical Study for New Drugs of Gansu Province, Basic Medical College, Lanzhou University, Lanzhou, Gansu, People's Republic of China; Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, People's Republic of China. FAU - Ding, Jiao AU - Ding J AD - Workers' Hospital of Jinchuan Group Co., Ltd., Jinchang, Gansu, People's Republic of China. FAU - Zheng, Tongzhang AU - Zheng T AD - Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island, United States. FAU - Bai, Yana AU - Bai Y AD - Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, People's Republic of China. LA - eng PT - Journal Article DEP - 20180213 PL - Canada TA - Can J Diabetes JT - Canadian journal of diabetes JID - 101148810 RN - EC 2.6.1.1 (Aspartate Aminotransferases) RN - EC 2.6.1.2 (Alanine Transaminase) RN - EC 3.4.11.7 (Glutamyl Aminopeptidase) SB - IM MH - Adult MH - Alanine Transaminase/blood MH - Aspartate Aminotransferases/blood MH - China/epidemiology MH - Cohort Studies MH - Diabetes Mellitus, Type 2/*enzymology/epidemiology MH - Fatty Liver/*enzymology/epidemiology MH - Female MH - Glutamyl Aminopeptidase/blood MH - Humans MH - Incidence MH - Liver/*enzymology MH - Male MH - Middle Aged MH - Predictive Value of Tests MH - Prospective Studies MH - Risk Assessment MH - Socioeconomic Factors OTO - NOTNLM OT - association OT - cohort OT - cohorte OT - diabete de type 2 OT - enzyme OT - enzymes OT - fatty liver OT - steatose hepatique OT - type 2 diabetes EDAT- 2018/06/25 06:00 MHDA- 2019/03/26 06:00 CRDT- 2018/06/25 06:00 PHST- 2017/06/14 00:00 [received] PHST- 2018/02/05 00:00 [accepted] PHST- 2018/06/25 06:00 [pubmed] PHST- 2019/03/26 06:00 [medline] PHST- 2018/06/25 06:00 [entrez] AID - S1499-2671(17)30342-8 [pii] AID - 10.1016/j.jcjd.2018.02.002 [doi] PST - ppublish SO - Can J Diabetes. 2018 Dec;42(6):652-658. doi: 10.1016/j.jcjd.2018.02.002. Epub 2018 Feb 13.