USA: Liver Enzymes and Diabetes Risk Among Latinos

A recent study published in the journal Diabetic Medicine finds that higher levels of liver enzymes ALT and GGT increase the risk of diabetes development among Latinos. This suggests that liver enzyme tests can identify high-risk individuals and might aid in diabetes prevention.

Non-alcoholic fatty liver disease (NAFLD) has been shown to increase the risk of incident diabetes. However, there is a lack of evidence in Hispanic/Latino populations, which have a high prevalence of NAFLD and obesity. To address this knowledge gap, Carmen R. Isasi from Albert Einstein College of Medicine, Bronx, NY, USA, and colleagues conducted a prospective cohort study involving 6,928 adults of Hispanic/Latino background. These participants had no diabetes, did not report excessive alcohol use, and had no hepatitis B and C infection at baseline (2008–2011).

The researchers estimated risk ratios (RR) for incident diabetes, identified from visit 2 examination by glucose measurements or antidiabetic medication use, with baseline liver enzymes (alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transpeptidase (GGT)).

Key Findings of the Study

• A total of 738 adults developed diabetes during 6 years of follow-up.
• After adjusting for participant characteristics at baseline, the highest quartiles of ALT and GGT were associated with increased risks for incident diabetes (RR for ALT: 1.51; RR for GGT: 2.39) compared to the lowest quartile.
• Higher GGT levels predicted an increased risk of incident diabetes even among those with ALT or AST below the median levels.
• The associations of ALT and GGT with incident diabetes were similar among most Hispanic backgrounds but were not observed among Dominicans.
• The association of AST with incident diabetes was found only among light-to-moderate alcohol drinkers (RR = 1.50) but not abstainers (RR = 0.91).

"Higher ALT and GGT levels are associated with an increased risk of developing diabetes among Latinos," wrote the authors. "Liver enzyme tests might aid in diabetes prevention by identifying high-risk individuals."

Reference

The study titled, "Association of liver enzymes with incident diabetes in US Hispanic/Latino adults," is published in the journal Diabetic Medicine.

DOI: https://onlinelibrary.wiley.com/doi/abs/10.1111/dme.14522