Increased alanine aminotransferase levels and associated characteristics among newly diagnosed type 2 diabetes patients: results from the DD2 study

Anil Mor; Reimar Thomsen; Jorgen Rungby; Sinna Ulrichsen; Jens Nielsen; Jacob Stidsen; Soren Friborg; Ivan Brandslund; Jens Christiansen; Henning Beck-Nielsen; Henrik Sorensen

doi:10.1530/endoabs.32.P358

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Endocrine Abstracts (2013) 32 P358 | DOI: 10.1530/endoabs.32.P358

ECE2013 Poster Presentations Diabetes (151 abstracts)

Increased alanine aminotransferase levels and associated characteristics among newly diagnosed type 2 diabetes patients: results from the DD2 study

Anil Mor ¹ , Reimar Thomsen ¹ , Jørgen Rungby ² , Sinna Ulrichsen ¹ , Jens Nielsen ³ , Jacob Stidsen ³ , Søren Friborg ³ , Ivan Brandslund ⁴ , Jens Christiansen ¹ , Henning Beck-Nielsen ³ & Henrik Sørensen ¹

Err

Author affiliations

¹Aarhus University Hospital, Aarhus, Denmark; ²Aarhus University, Aarhus, Denmark, ³Odense University Hospital, Odense, Denmark; ⁴Lillebælt Hospital, Vejle, Denmark.

Objectives: Elevated levels of serum alanine aminotransferase (ALAT) have been linked with non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), insulin resistance and the metabolic syndrome in type 2 diabetes (T2D) patients. We examined ALAT levels in newly diagnosed T2D patients, and the factors associated with such elevation.

Methods: Measurements of ALAT were performed in 1025 (43% women and 57% men) new T2D patients enrolled from general practitioners and hospital specialist outpatient clinics in the nationwide DD2 project. We calculated the median value of ALAT, and examined the number of T2D patients within gender specific quartiles of ALAT values. We also examined demographic, clinical, and lifestyle characteristics associated with increased ALAT levels. Data on BMI, lipid profile and blood pressure could be ascertained from the Danish Diabetes Database for Adults for a subgroup (n=525) of the study population.

Results: The median value of ALAT was 24 IU/l (inter-quartile range 18–32 IU/l) in women and 30 IU/l (inter-quartile range 22–41 IU/l) in men. 26% were in the lowest ALAT quartile (<18 IU/l for women and <22 IU/l for men, respectively) and 24% were in the highest ALAT quartile (>32 IU/l/>41 IU/l for women/men). As compared to people with ALAT values in the lowest quartile, those with high ALAT were younger (median age 57 vs 64 years, P<0.0001), more obese (median BMI 31.2 vs 29.1 kg/m², P=0.004), and had a larger waist circumference (111 vs 101 cm, P<0.0001) and higher median CRP levels (2.8 vs 1.8 mg/l, P=0.0147). They also had substantially poorer glucose control (HbA1c 7.40 vs 6.90%, P=0.084; fasting blood glucose 7.56 vs 6.86 mmol/l, P<0.0001), and a worse lipid profile (total-cholesterol 4.70 vs 4.15 mmol/l, P=0.006), whereas blood pressure was similar between groups. Patients in the highest ALAT quartile had more alcohol overuse (10.4 vs 2.2% with >14/21 weekly drinks in women/men, P<0.0001) as compared to subjects in the lowest quartile.

Conclusions: Among newly diagnosed T2D patients, those with a high ALAT level were younger, had more abdominal obesity, dyslipidemia, poorer glucose control, more alcohol overuse, and higher CRP levels as compared with those in the lowest ALAT quartile.