Dr. Ron’s Research Review – January 13, 2016

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This week’s research review focuses on liver enzymes and metabolic syndrome.

The Heinz Nixdorf RECALL Study found that normal liver enzymes were correlated with severity of metabolic syndrome in a large population based cohort (n = 4814, age 45 to 75 y). (Kälsch et al., 2015)

ALT and AST values were significantly higher in males than in females. Mean BMI was 27.9 kg/m(2) and type-2-diabetes (known and unknown) was present in 656 participants (13.7%). Adiponectin and vitamin D both correlated inversely with BMI. ALT, AST, and GGT correlated with BMI, CRP and HbA1c and inversely correlated with adiponectin levels. Logistic regression models using HbA1c and adiponectin or HbA1c and BMI were able to predict diabetes with high accuracy. Transaminase levels within normal ranges were closely associated with the BMI and diabetes risk. Transaminase levels and adiponectin were inversely associated.

 Parameters that predicted diabetes in this study included: HbA1c, Adiponectin, BMI, GGT, Vitamin D, CRP, ALT and AST.
ALT, AST, and GGT in the presented cohort were each correlated with HbA1c levels and BMI. Additionally, GGT was associated with CRP, suggesting a connection to systemic inflammation beyond metabolic associations. This may support GGT as biomarker for atherosclerosis.

      
Dr. Ron


 

Articles

Normal liver enzymes are correlated with severity of metabolic syndrome in a large population based cohort.
            (Kälsch et al., 2015) Download
Key features of the metabolic syndrome are insulin resistance and diabetes. The liver as central metabolic organ is not only affected by the metabolic syndrome as non-alcoholic fatty liver disease (NAFLD), but may contribute to insulin resistance and metabolic alterations. We aimed to identify potential associations between liver injury markers and diabetes in the population-based Heinz Nixdorf RECALL Study. Demographic and laboratory data were analyzed in participants (n = 4814, age 45 to 75 y). ALT and AST values were significantly higher in males than in females. Mean BMI was 27.9 kg/m(2) and type-2-diabetes (known and unkown) was present in 656 participants (13.7%). Adiponectin and vitamin D both correlated inversely with BMI. ALT, AST, and GGT correlated with BMI, CRP and HbA1c and inversely correlated with adiponectin levels. Logistic regression models using HbA1c and adiponectin or HbA1c and BMI were able to predict diabetes with high accuracy. Transaminase levels within normal ranges were closely associated with the BMI and diabetes risk. Transaminase levels and adiponectin were inversely associated. Re-assessment of current normal range limits should be considered, to provide a more exact indicator for chronic metabolic liver injury, in particular to reflect the situation in diabetic or obese individuals.

 

References

Kälsch, J, et al. (2015), ‘Normal liver enzymes are correlated with severity of metabolic syndrome in a large population based cohort.’, Sci Rep, 5 13058. PubMedID: 26269425