Alanine aminotransferase/aspartate aminotransferase ratio is the best surrogate marker for insulin resistance in non-obese Japanese adults

作者：Kawamoto Ryuichi^*; Kohara Katsuhiko; Kusunoki Tomo; Tabara Yasuharu; Abe Masanori; Miki Tetsuro

来源：Cardiovascular Diabetology, 2012, 11(1): 117.

DOI：10.1186/1475-2840-11-117

• ALT/AST ratio
• Insulin resistance
• Marker
• Body mass index

Background: The aim of the present study was to examine how liver markers are associated with insulin resistance in Japanese community-dwelling adults. %26lt;br%26gt;Methods: This cross-sectional study included 587 men aged 58 +/- 14 (mean +/- standard deviation; range, 20-89) years and 755 women aged 60 +/- 12 (range, 21-88) years. The study sample consisted of 998 (74.4%) non-obese [ body mass index (BMI) %26lt; 25.0 kg/m(2)] and 344 (25.6%) overweight (BMI %26gt;= 25 kg/m(2)) subjects. Insulin resistance was defined by homeostasis model assessment of insulin resistance (HOMA-IR) of at least 2.5, and HOMA-IR and potential confounders were compared between the groups. Areas under the curve (AUC) of the receiver operating characteristic curves (ROC) were used to compare the power of these serum markers. %26lt;br%26gt;Results: In non-obese subjects, the best marker of insulin resistance was alanine aminotransferase (ALT)/aspartate aminotransferase (AST) ratio of 0.70 (95% confidence interval (CI), 0.63-0.77). In overweight subjects, AUC values for the ALT/AST ratio and ALT were 0.66 (0.59-0.72) and 0.66 (0.59-0.72), respectively. Multiple linear regression analyses for HOMA-IR showed that ALT/AST ratios were independently and significantly associated with HOMA-IR as well as other confounding factors in both non-obese and overweight subjects. The optimal cut-off point to identifying insulin resistance for these markers yielded the following values: ALT/AST ratio of %26gt;= 0.82 in non-obese subjects and %26gt;= 1.02 in overweight subjects. In non-obese subjects, the positive likelihood ratio was greatest for ALT/AST ratio. %26lt;br%26gt;Conclusions: In non-obese Japanese adults, ALT/AST ratio may be the best reliable marker of insulin resistance.

• 出版日期2012-10-1