Diabetes & Metabolism Journal
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Published By Korean Diabetes Association (Kamje)

2233-6087, 2233-6079
Updated Monday, 17 January 2022

Hyun Ho Choi ◽  
Giwoong Choi ◽  
Hojun Yoon ◽  
Kyoung Hwa Ha ◽  
Dae Jung Kim

Woo-Hwi Jeon ◽  
Jeong-Yeon Seon ◽  
So-Youn Park ◽  
In-Hwan Oh

2021 ◽  
Vol 45 (6) ◽  
pp. 890-898
Kyuhoon Bang ◽  
Ji Eun Jun ◽  
In-Kyung Jeong ◽  
Kyu Jeung Ahn ◽  
Ho Yeon Chung ◽  

Background: Fatty liver and/or increased liver enzyme values have been reported to be associated with incident diabetes. We sought to determine whether increased visit-to-visit liver enzyme variability is associated with incident diabetes.Methods: Study participants were recruited from the Korean Genome and Epidemiologic Study (KoGES). A total of 4,151 people aged 40 to 69 years was recruited and tested every 2 years for up to 12 years. Visit-to-visit aspartate aminotransferase (AST) and alanine aminotransferase (ALT) variability was evaluated in first the 6-year period through the use of various variability measurements: standard deviation (SD), average successive variability, coefficient of variation (CV), and variation independent of mean (VIM). Oral glucose tolerance test was performed at every visit.Results: During the 6-year follow‐up appointments, 13.0% (538/4,151) of people developed incident diabetes. Visit-to-visit AST variability was associated with an increased risk of diabetes independent of conventional risk factors for diabetes (hazard ratio per 1-SD increment [95% confidence interval]: 1.06 [1.00 to 1.11], 1.12 [1.04 to 1.21], and 1.13 [1.04 to 1.22] for SD, CV, and VIM, respectively; all P<0.05); however, no such associations were observed in the visit-to-visit ALT variability. According to alcohol consumption status, both AST and ALT variability were independent predictors for incident diabetes in subjects with heavy alcohol consumption; however, neither AST nor ALT variability was associated with diabetes risk in subjects who did not drink alcohol heavily.Conclusion: Visit-to-visit liver enzyme variability is an independent predictor of incident diabetes. Such association was more evident in those who consumed significant amounts of alcohol.

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