Association between aspartate aminotransferase-to-alanine aminotransferase ratio and insulin resistance among US adults.
Eur J Gastroenterol Hepatol
; 34(3): 316-323, 2022 03 01.
Article
em En
| MEDLINE
| ID: mdl-34074988
ABSTRACT
OBJECTIVE:
To determine whether a low aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AST/ALT ratio) is associated with insulin resistance among those without liver dysfunction.METHODS:
In this cross-sectional study of the National Health and Nutrition Examination Survey (NHANES) 2011-2016, we included 2747 (1434 male and 1313 nonpregnant female) adults ≥20 years without evidence of liver dysfunction (ALT<30 in male and <19 in female, negative viral serologies, no excess alcohol consumption, no elevated transferrin saturation, AST/ALT <2). Serum AST/ALT ratio was categorized into sex-specific quartiles (female <1.12, 1.12-1.29, 1.29-1.47, ≥1.47 and male <0.93, 0.93-1.09, 1.09-1.26, ≥1.26). The primary outcome was insulin resistance, as determined by Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) index score ≥3. Covariate-adjusted odds ratios (ORs) were estimated. Study analysis completed from 13 March 2020 to 21 April 2021.RESULTS:
Among the 2747 individuals, 33% had insulin resistance. Those in the lowest quartile (Q1) of AST/ALT had 75% higher adjusted odds of insulin resistance compared to the highest quartile (Q4) [aOR (95% confidence interval (CI), 1.75 (1.20-2.57)]. This association was more pronounced in those with elevated BMI [Q1 vs. Q4; BMI ≥ 25 2.29 (1.58-3.33), BMI < 25 0.66 (0.26-1.69); NAFLD per Fatty Liver Index ≥ 60 2.04 (1.21-3.44), No NAFLD 1.68 (0.94-3.01)].CONCLUSION:
Lower AST/ALT ratio is associated with increased insulin resistance among those with healthy-range ALT, especially in those with BMI greater than or equal to 25 kg/m2.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Resistência à Insulina
/
Hepatopatia Gordurosa não Alcoólica
Tipo de estudo:
Diagnostic_studies
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
Idioma:
En
Revista:
Eur J Gastroenterol Hepatol
Assunto da revista:
GASTROENTEROLOGIA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Estados Unidos