背景:低水平的高密度脂蛋白胆固醇(HDL-C)和高水平的丙氨酸氨基转移酶(ALT)与胰岛素抵抗有关,代谢综合征,糖尿病(DM)。然而,丙氨酸转氨酶与高密度脂蛋白胆固醇(ALT/HDL-C)比值与糖尿病(DM)风险相关的证据有限.该研究旨在探讨基线ALT/HDL-C比值与糖尿病之间的关系。
方法:第二个分析基于使用开源数据的队列研究。2004年至2015年期间,日本村上纪念医院记录了参加体检计划的15342人的数据。平滑曲线拟合,亚组分析,Cox比例风险回归,并进行了一系列敏感性分析,以检查ALT/HDL-C比值与糖尿病发病之间的关系.使用受试者工作特征曲线分析评估ALT/HDL-C比率预测糖尿病的能力。
结果:控制混杂协变量后,在日本成年人中,ALT/HDL-C比值与DM风险呈正相关(HR:1.01,95CI:1.00-1.02,P=0.049).这项研究还发现了ALT/HDL-C比值与糖尿病之间的稳定关系,采用了一系列的敏感性分析。此外,ALT/HDL-C比值与糖尿病发病之间存在非线性关联,ALT/HDL-C比值拐点为30.12。当ALT/HDL-C比值低于30.12时,本研究发现ALT/HDL-C比值与糖尿病发病率之间存在显著正相关(HR:1.04,95CI:1.02-1.06,P=0.001)。此外,在肝酶中,血脂,和人体测量指标,ALT/HDL-C比值最好地预测DM(AUC=0.75,95CI:0.73-0.78)。
结论:基线时ALT/HDL-C比值水平升高与糖尿病相关。ALT/HDL-C比值与糖尿病发病之间也呈非线性关系。当ALT/HDL-C比率低于30.12时,ALT/HDL-C比率与发生的DM之间存在统计学上显著的正相关性。
BACKGROUND: Low levels of high-density lipoprotein cholesterol (HDL-C) and high levels of alanine aminotransferase (ALT) are related to insulin resistance, metabolic syndrome, and diabetes mellitus (DM). However, evidence on the connection between the alanine aminotransferase to high-density lipoprotein cholesterol (ALT/HDL-C) ratio and diabetes mellitus (DM) risk was limited. The study aimed to investigate the relationship between baseline ALT/HDL-C ratio and DM among Japanese individuals.
METHODS: This second analysis was based on a cohort study using open-source data. Data from 15,342 individuals who participated in the medical examination program were recorded at Murakami Memorial Hospital in Japan between 2004 and 2015. Smooth curve fitting, subgroup analysis, Cox proportional-hazards regression, and a series of sensitivity analyses were conducted to examine the relationship between ALT/HDL-C ratio and incident diabetes. The ability of the ALT/HDL-C ratio to predict diabetes was evaluated using a receiver operating characteristic curve analysis.
RESULTS: After controlling for confounding covariates, the ALT/HDL-C ratio was found to be positively correlated to the DM risk in Japanese adults (HR: 1.01, 95%CI: 1.00-1.02, P = 0.049). This study also found a stable relationship between ALT/HDL-C ratio and diabetes after employing a series of sensitivity analyses. Additionally, there was a non-linear association between the ALT/HDL-C ratio and incident diabetes, and the ALT/HDL-C ratio inflection point was 30.12. When the ALT/HDL-C ratio was below 30.12, the present study discovered a significant positive association between the ALT/HDL-C ratio and incident diabetes (HR: 1.04, 95%CI: 1.02-1.06, P = 0.001). Furthermore, among liver enzymes, blood lipids, and anthropometric indicators, the ALT/HDL-C ratio best predicts DM (AUC = 0.75, 95%CI: 0.73-0.78).
CONCLUSIONS: Increased ALT/HDL-C ratio levels at baseline correlated to incident DM. The relationship between ALT/HDL-C ratio and incident DM was also non-linear. When the ALT/HDL-C ratio is below 30.12, there is a statistically significant positive correlation between the ALT/HDL-C ratio and incident DM.