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01.12.2012 | Original investigation | Ausgabe 1/2012 Open Access

Cardiovascular Diabetology 1/2012

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

Zeitschrift:
Cardiovascular Diabetology > Ausgabe 1/2012
Autoren:
Ryuichi Kawamoto, Katsuhiko Kohara, Tomo Kusunoki, Yasuharu Tabara, Masanori Abe, Tetsuro Miki
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1475-2840-11-117) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

RK, YT, and KK participated in the design of the study, performed the statistical analysis and drafted the manuscript. TK and AM contributed to acquisition of data and its interpretation. RK and MA contributed to conception and design of the statistical analysis. TM conceived of the study, participated in its design, coordination and helped to draft the manuscript. All authors read and approved the manuscript.

Abstract

Background

The aim of the present study was to examine how liver markers are associated with insulin resistance in Japanese community-dwelling adults.

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) <25.0 kg/m2] and 344 (25.6%) overweight (BMI ≥25 kg/m2) 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.

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 ≥0.82 in non-obese subjects and ≥1.02 in overweight subjects. In non-obese subjects, the positive likelihood ratio was greatest for ALT/AST ratio.

Conclusions

In non-obese Japanese adults, ALT/AST ratio may be the best reliable marker of insulin resistance.
Zusatzmaterial
Authors’ original file for figure 1
12933_2012_544_MOESM1_ESM.jpeg
Authors’ original file for figure 2
12933_2012_544_MOESM2_ESM.tiff
Literatur
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