High Liver Enzyme Concentrations are Associated with Higher Glycemia, but not with Glycemia Variability, in Individuals without Diabetes Mellitus

作者：Noordam Raymond^*; Vermond Debbie; Drenth Hermijntje; Wijman Carolien A; Akintola Abimbola A; van der Kroef Sabrina; Jansen Steffy W M; Huurman Neline C; Schutte Bianca A M; Beekman Marian; Slagboom P Eline; Mooijaart Simon P; van Heemst Diana

来源：Frontiers in Endocrinology, 2017, 8: 236.

DOI：10.3389/fendo.2017.00236

• continuous glucose monitoring
• liver enzymes
• glycemia
• glycemic variability
• cross-sectional cohort study

Background: Elevated concentrations of liver enzymes have been associated with an increased risk of developing type 2 diabetes mellitus. However, it remains unclear to which specific aspects of diurnal glucose metabolism these associate most. We aimed to investigate the associations between liver enzyme concentrations and 24 h-glucose trajectories in individuals without diabetes mellitus from three independent cohorts.
Methods: This cross-sectional study included 436 participants without diabetes mellitus from the Active and Healthy Aging Study, the Switchbox Study, and the Growing Old Together Study. Fasting blood samples were drawn to measure gammaglutamyltransferase (GGT), alanine transaminase, and aspartate transaminase. Measures of glycemia (e.g., nocturnal and diurnal mean glucose levels) and glycemic variability (e.g., mean amplitude of glucose excursions) were derived from continuous glucose monitoring. Analyses were performed separately for the three cohorts; derived estimates were additionally meta-analyzed.
results: After meta-analyses of the three cohorts, elevated liver enzyme concentrations, and specifically elevated GGT concentrations, were associated with higher glycemia. More specific, participants in the highest GGT tertile (GGT >= 37.9 U/L) had a 0.39 mmol/L (95% confidence interval: 0.23, 0.56) higher mean nocturnal glucose (3: 00 to 6: 00 a. m.) and a 0.23 mmol/L (0.10, 0.36) higher diurnal glucose (6: 00 to 0: 00 a. m.) than participants in the lowest GGT tertile (GGT <21.23 U/L). However, elevated liver enzyme concentrations were not associated with a higher glycemic variability.
conclusion: Though elevated liver enzyme concentrations did not associate with higher glycemic variability in participants without diabetes mellitus, specifically, elevated GGT concentrations associated with higher glycemia.

• 出版日期2017-9-13