Association between serum transaminase levels and insulin resistance in euthyroid and non-diabetic adults.

AIM: To evaluate the association between elevated serum transaminase levels and insulin resistance (IR) in a population of healthy individuals. METHODS: We define IR with a cut-off point of homeostatic model assessment (HOMA-IR) ≥ 3.8. For aspartate aminotransferase (AST), we consider elevated values >30 U/L in women and values >36 U/L in men. For alanine aminotransferase (ALT), we consider elevated values >30 U/L in women and values >40 U/L in men. We performed a crude and adjusted generalized linear model from Poisson family with robust variance, in order to evaluate the association between elevated serum transaminase levels and IR. The associations were presented as prevalence ratio (PR) with their respective 95% confidence intervals (95% CI). RESULTS: We included 261 participants in the study. The median age was 39 years (31-45) and 23.7% of the participants were men. The prevalence of elevated serum transaminase for AST and ALT were, 13.8% and 26.1%, respectively. The prevalence of IR was 34.1%. In the crude analysis we found statistical significance between elevated AST and ALT with IR (PR = 3.18; 95% CI: 2.33-4.34 and PR = 2.44; 95% CI: 1.88-3.30; respectively). However, in the multivariate analysis, the association only remained statistically significance with ALT, but lost its significance with AST, PR = 1.90; CI 95%: 1.31-2.77 and a PR = 1.23; CI 95%: 0.93-1.61; respectively. CONCLUSION: Elevated serum levels of ALT were associated with insulin resistance. ALT could be used in clinical practice as an additional tool to assess IR in apparently healthy people.

Relationship between body fat percentage and insulin resistance in adults with Bmi values below 25 Kg/M2 in a private clinic.

AIM: To evaluate the association between elevated body fat percent (BF%) and the prevalence of insulin resistance (IR) in the adult population with body mass index (BMI) in the normal values. METHODS: We carry out an analytical cross-sectional study. The participants attended outpatient from 2012 to 2016 in a private clinic in Lima-Peru between 18 and 60 years with a BMI between 19 and 24.9/Kg/m2. We defined elevated BF% if the values were greater than 25% in men and 30% in women and IR with a cut-off point of HOMA-IR based in the 75th percentile. We performed a generalized linear model from family Poisson (crude and adjusted) with robust standard errors to evaluate the association between BF% and the IR. We reported as association measure the prevalence ratio (PR) with their respective 95% confidence intervals (CI). RESULTS: We included 284 participants, the average age was 33.77 ±â€¯10.86 (SD) years and the percentage of women was 88.1%. The prevalence of elevated BF% was 71.13% and the prevalence of IR was 25%. We found an association between the elevated BF% and IR, PR = 3.17; 95% CI: 1.46-6.91. CONCLUSIONS: Body fat percentage seems to be a good indicator of IR in patients with normal BMI and without endocrine comorbidities. Longitudinal prospective studies are recommended to corroborate our findings.

High triglycerides to HDL-cholesterol ratio is associated with insulin resistance in normal-weight healthy adults.

AIM: To evaluate the association between high triglyceride/HDL-cholesterol (TG/HDL-C) ratio and insulin resistance (IR) or hyperinsulinemia after oral glucose tolerance test (OGTT) in normal-weight healthy adults. METHODS: We carried out an analytical cross-sectional study in euthyroid non-diabetic adults, who attended the outpatient service of a private clinic in Lima-Peru from 2012 to 2016. Participants were divided in two groups according to the presence or absence of high TG/HDL-C ratio, IR or hyperinsulinemia after OGTT. TG/HDL-C ratio values ≥ 3 were considered as high. IR was defined as a Homeostasis Model Assessment (HOMA-IR) value ≥ 2.28 and hyperinsulinemia after OGTT as a serum insulin value ≥ 80µU/mL after 120 min of 75-g glucose intake. We elaborated crude and adjusted Poisson generalized linear models to evaluate the association between high TG/HDL-C ratio and IR or hyperinsulinemia after OGTT and reported the prevalence ratio (PR) with their respective 95% confidence intervals (95%CI). RESULTS: We analyzed the data of 118 individuals. Prevalence of high TG/HDL-C ratio was 17.8% (n = 21) while the prevalence of IR and hyperinsulinemia after OGTT was 24.6% (n = 29) and 17.0% (n = 20), respectively. TG/HDL-C-ratio values were positively correlated with HOMA-IR (r = 0.498; p < 0.01) and serum insulin after OGTT (r = 0.326; p < 0.001). In the adjusted model, high TG/HDL-C ratio was associated with both IR (aPR = 3.16; 95%CI: 1.80-5.77) and hyperinsulinemia after OGTT (aPR = 2.36; 95%CI: 1.20-4.63). CONCLUSIONS: High TG/HDL-C ratio was associated with both IR markers used in our study, appearing to be a clinically useful tool to assess IR in euthyroid normal-weight adults without type 2 diabetes mellitus.