■这项研究旨在检查肝酶的相关性,包括丙氨酸转氨酶(ALT),天冬氨酸转氨酶(AST),和γ-谷氨酰转移酶(GGT),患有2型糖尿病(T2D)的风险,特别是它们的剂量-反应关系。
■这项横断面研究招募了年龄>20岁的参与者,他们于2022年11月至2023年5月在我们当地医院接受了体检。广义加性模型(GAM)适合评估肝酶和T2D风险之间的剂量反应关系。此外,我们分析了来自英国生物库(n=217,533)和国家健康和营养检查调查(NHANES2011-2018;n=15,528)的数据,以评估肝酶和T2D之间的剂量-反应关系是否因人群差异而有所不同.
■共有14,100名参与者(1,155名T2D患者和12,945名无糖尿病患者)纳入分析。GAM显示肝酶与T2D风险之间存在非线性关系(P非线性<0.001)。具体来说,T2D风险随着ALT和GGT水平的增加而增加(范围,<50IU/L),然后在ALT和GGT水平>50IU/L时达到稳定。在一定范围内升高的AST(范围,<35IU/L)降低了T2D的风险,而轻度升高的AST(>35IU/L)成为T2D的危险因素。英国生物银行和NHANES数据分析也显示肝酶和T2D发病率之间的类似非线性模式。
■肝酶与不同人群的T2D风险呈非线性相关,包括中国,英国,和美国。ALT和GGT水平升高,在一定范围内,可能会增加T2D风险。早期生活方式干预和早期T2D预防应重视肝酶水平。需要进一步的研究来探索肝酶与T2D风险之间的非线性关联的机制。
This
study aimed to examine the association of liver enzymes, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl-transferase (GGT), with type 2 diabetes (T2D) risk, particularly their dose-response relationship.
This cross-sectional
study enrolled participants aged >20 years old who underwent physical examination at our local hospital from November 2022 to May 2023. A generalized additive model (GAM) was fit to assess the dose-response relationship between liver enzymes and T2D risk. Furthermore, data from the UK Biobank (n=217,533) and National Health and Nutrition Examination Survey (NHANES 2011-2018; n= 15,528) were analyzed to evaluate whether the dose-response relationship between liver enzymes and T2D differed by population differences.
A total of 14,100 participants were included (1,155 individuals with T2D and 12,945 individuals without diabetes) in the analysis. GAM revealed a non-linear relationship between liver enzymes and T2D risk (P non-linear < 0.001). Specifically, T2D risk increased with increasing ALT and GGT levels (range, <50 IU/L) and then plateaued when ALT and GGT levels were >50 IU/L. Elevated AST within a certain range (range, <35 IU/L) decreased the risk of T2D, whereas mildly elevated AST (>35 IU/L) became a risk factor for T2D. The UK Biobank and NHANES data analysis also showed a similar non-linear pattern between liver enzymes and T2D incidence.
Liver enzymes were non-linearly associated with T2D risk in different populations, including China, the UK, and the US. Elevated ALT and GGT levels, within a certain range, could increase T2D risk. More attention should be given to liver enzyme levels for early lifestyle intervention and early T2D prevention. Further studies are necessary to explore the mechanism of the non-linear association between liver enzymes and T2D risk.