TY - JOUR
T1 - Association of gamma-glutamyl transferase and alanine aminotransferase with type 2 diabetes mellitus incidence in middle-aged Japanese men
T2 - 12-year follow up
AU - Kaneko, Kayo
AU - Yatsuya, Hiroshi
AU - Li, Yuanying
AU - Uemura, Mayu
AU - Chiang, Chifa
AU - Hirakawa, Yoshihisa
AU - Ota, Atsuhiko
AU - Tamakoshi, Koji
AU - Aoyama, Atsuko
N1 - Funding Information:
The authors thank the participants and the healthcare personnel of the local government office. This work was supported in part by MEXT/JSPS KAKENHI (grant numbers 13470087 and 17390185 to Professor Emeritus Hideaki Toyoshima; 17790384, 22390133, 23659346, 26293153 and 18H03057 to Hiroshi Yat-suya; 16590499, 18590594, 20590641 and 23590787, 15K08802 to Koji Tamakoshi; and 25893088 and 16K19278 to Yuanying Li), Health and Labor Sciences research grants for Comprehensive Research on Cardiovascular and Life-Style Related Diseases (H26-Junkankitou [Seisaku]-Ippan-001 and H29-Junkankitou [Seishuu]-Ippan-003) from the Ministry of Health, Labor and Welfare, and research grants from the Japan Atherosclerosis Prevention Fund (to Hiroshi Yatsuya), the Aichi Health Promotion Foundation (to Hiroshi Yatsuya) and the Uehara Memorial Fund (to Hiroshi Yatsuya).
Funding Information:
The authors thank the participants and the healthcare personnel of the local government office. This work was supported in part by MEXT/JSPS KAKENHI (grant numbers 13470087 and 17390185 to Professor Emeritus Hideaki Toyoshima; 17790384, 22390133, 23659346, 26293153 and 18H03057 to Hiroshi Yatsuya; 16590499, 18590594, 20590641 and 23590787, 15K08802 to Koji Tamakoshi; and 25893088 and 16K19278 to Yuanying Li), Health and Labor Sciences research grants for Comprehensive Research on Cardiovascular and Life-Style Related Diseases (H26-Junkankitou [Seisaku]-Ippan-001 and H29-Junkankitou [Seishuu]-Ippan-003) from the Ministry of Health, Labor and Welfare, and research grants from the Japan Atherosclerosis Prevention Fund (to Hiroshi Yatsuya), the Aichi Health Promotion Foundation (to Hiroshi Yatsuya) and the Uehara Memorial Fund (to Hiroshi Yatsuya).
Publisher Copyright:
© 2018 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd
PY - 2019/5
Y1 - 2019/5
N2 - Aims/Introduction: To prospectively investigate whether simultaneous elevation of gamma-glutamyl transferase (GGT) and alanine aminotransferase (ALT) is associated with the increase of type 2 diabetes mellitus incidence independent of alcohol drinking, body mass index and triglycerides. Methods: A total of 2,775 Japanese male workers who had no history of type 2 diabetes mellitus were followed. High GGT and ALT were defined as the top tertiles (GGT cutpoint: 49 IU/L, ALT cutpoint: 28 IU/L). Three groups were created using these dichotomized GGT and ALT cutpoints: both low, either high or both high. Multivariable Cox proportional hazards models were carried out adjusted for potential confounding factors. Results: A total of 276 type 2 diabetes mellitus cases were identified during 12 years (27,040 person-years) of follow up. Participants with simultaneously elevated GGT and ALT had a significantly higher incidence of type 2 diabetes mellitus, even after adjustment for fasting insulin and fasting blood glucose compared with the group without GGT or ALT elevation. Similar associations were observed in non- or light-to-moderate alcohol drinkers, as well as in participants with normal weight. However, the association was weaker in participants with triglycerides <150 mg/dL. We then evaluated whether the addition of GGT and ALT would improve the prediction of type 2 diabetes mellitus incidence, and found that their inclusion significantly increased the C-statistic, net reclassification improvement and integrated discrimination improvement. Conclusions: Simultaneous elevation of GGT and ALT was significantly associated with type 2 diabetes mellitus incidence, independent of potential confounding factors, including alcohol drinking and obesity, although the association might require concomitant elevation of triglycerides. Inclusion of GGT and ALT improved type 2 diabetes mellitus risk prediction.
AB - Aims/Introduction: To prospectively investigate whether simultaneous elevation of gamma-glutamyl transferase (GGT) and alanine aminotransferase (ALT) is associated with the increase of type 2 diabetes mellitus incidence independent of alcohol drinking, body mass index and triglycerides. Methods: A total of 2,775 Japanese male workers who had no history of type 2 diabetes mellitus were followed. High GGT and ALT were defined as the top tertiles (GGT cutpoint: 49 IU/L, ALT cutpoint: 28 IU/L). Three groups were created using these dichotomized GGT and ALT cutpoints: both low, either high or both high. Multivariable Cox proportional hazards models were carried out adjusted for potential confounding factors. Results: A total of 276 type 2 diabetes mellitus cases were identified during 12 years (27,040 person-years) of follow up. Participants with simultaneously elevated GGT and ALT had a significantly higher incidence of type 2 diabetes mellitus, even after adjustment for fasting insulin and fasting blood glucose compared with the group without GGT or ALT elevation. Similar associations were observed in non- or light-to-moderate alcohol drinkers, as well as in participants with normal weight. However, the association was weaker in participants with triglycerides <150 mg/dL. We then evaluated whether the addition of GGT and ALT would improve the prediction of type 2 diabetes mellitus incidence, and found that their inclusion significantly increased the C-statistic, net reclassification improvement and integrated discrimination improvement. Conclusions: Simultaneous elevation of GGT and ALT was significantly associated with type 2 diabetes mellitus incidence, independent of potential confounding factors, including alcohol drinking and obesity, although the association might require concomitant elevation of triglycerides. Inclusion of GGT and ALT improved type 2 diabetes mellitus risk prediction.
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U2 - 10.1111/jdi.12930
DO - 10.1111/jdi.12930
M3 - Article
C2 - 30204299
AN - SCOPUS:85054915833
SN - 2040-1116
VL - 10
SP - 837
EP - 845
JO - Journal of Diabetes Investigation
JF - Journal of Diabetes Investigation
IS - 3
ER -