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Potential impact of joint association of alanine aminotransferase and gamma‐glutamyltransferase on insulin resistance in J apan: The T oranomon H ospital H ealth M anagement C enter S tudy 19 ( TOPICS 19)
Author(s) -
Arase Yasuji,
Heianza Yoriko,
Hara Shigeko,
OhmotoSekine Yuki,
Amakawa Kazuhisa,
Tsuji Hiroshi,
Ogawa Kyoko,
Saito Kazumi,
Kodama Satoru,
Ikeda Kenji,
Kumada Hiromitsu,
Kobayashi Tetsuro,
Sone Hirohito
Publication year - 2015
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12343
Subject(s) - insulin resistance , medicine , gamma glutamyltransferase , alanine aminotransferase , insulin , endocrinology , homeostasis , chemistry , enzyme , biochemistry
Aim To investigate the potential impact of joint association of alanine aminotransferase ( ALT ) and γ‐glutamyltransferase ( GGT ) on insulin resistance and β‐cell dysfunction in healthy Japanese individuals with a normal range of liver enzymes. Methods This study included 1010 individuals (545 men and 465 women) aged 20–89 years who underwent an oral glucose tolerance test for health screening. Participants were divided into four groups on the basis of median values for ALT and GGT : (i) both ALT and GGT low (both‐low); (ii) ALT high and GGT low ( ALT ‐high); (iii) ALT low and GGT high ( GGT ‐high); and (iv) both ALT and GGT high (both‐high). Logistic regression analysis was used to investigate the relationship between liver enzyme and insulin dynamics, such as H omeostasis M odel of A ssessment – I nsulin R esistance ( HOMA‐IR ) and insulinogenic index ( IGI ). The insulin resistance was defined when HOMA‐IR was 2.5 or more. IGI of less than 0.4 was considered to be decreased early‐phase insulin secretion.Results Mean values of HOMA‐IR in men was 1.5 in the both‐low group, 1.8 in ALT ‐high, 1.8 in GGT ‐high and 2.8 in both‐high. The mean HOMA‐IR in women was 1.3 in the both‐low group, 1.3 in ALT ‐high, 1.6 in GGT ‐high and 2.0 in both‐high. HOMA‐IR in the both‐high group was significantly higher than that in the both‐low group regardless of the difference of sex. Multivariate analysis showed that insulin resistance occurred when the patient had high liver enzymes. Conclusion Combining the two liver function markers would be effective for identifying individuals with insulin resistance.