Alanine aminotransferase-aspartate aminotransferase ratio is the best surrogate marker for insulin resistance in non-obese Japanese adultsReport as inadecuate




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Cardiovascular Diabetology

, 11:117

First Online: 01 October 2012Received: 09 August 2012Accepted: 20 September 2012

Abstract

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

MethodsThis 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-m and 344 25.6% overweight BMI ≥25 kg-m 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.

ResultsIn 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.

ConclusionsIn non-obese Japanese adults, ALT-AST ratio may be the best reliable marker of insulin resistance.

KeywordsALT-AST ratio Insulin resistance Marker Body mass index Electronic supplementary materialThe online version of this article doi:10.1186-1475-2840-11-117 contains supplementary material, which is available to authorized users.

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Author: Ryuichi Kawamoto - Katsuhiko Kohara - Tomo Kusunoki - Yasuharu Tabara - Masanori Abe - Tetsuro Miki

Source: https://link.springer.com/article/10.1186/1475-2840-11-117



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