Circulating alanine transaminase (ALT) and γ-glutamyl transferase (GGT), but not fetuin-A, are associated with metabolic risk factors, at baseline and at two-year follow-up: the prospective Cyprus Metabolism Study

doi:10.1016/j.metabol.2014.03.008

Comparative Study

. 2014 Jun;63(6):773-82.

doi: 10.1016/j.metabol.2014.03.008. Epub 2014 Mar 15.

Circulating alanine transaminase (ALT) and γ-glutamyl transferase (GGT), but not fetuin-A, are associated with metabolic risk factors, at baseline and at two-year follow-up: the prospective Cyprus Metabolism Study

Xiaowen Liu¹, Ole-Petter R Hamnvik², John P Chamberland³, Michael Petrou⁴, Huizhi Gong¹, Costas A Christophi⁵, David C Christiani⁶, Stefanos N Kales⁷, Christos S Mantzoros⁸

Affiliations

¹ Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA.
² Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
³ Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; Section of Endocrinology, Boston VA Healthcare System, Boston, MA.
⁴ Cyprus International Institute for Environmental and Public Health in association with Harvard School of Public Health, Cyprus University of Technology, Limassol, Cyprus.
⁵ Cyprus International Institute for Environmental and Public Health in association with Harvard School of Public Health, Cyprus University of Technology, Limassol, Cyprus; Department of Environmental Health, Harvard School of Public Health, Boston, MA.
⁶ Department of Environmental Health, Harvard School of Public Health, Boston, MA.
⁷ Department of Environmental Health, Harvard School of Public Health, Boston, MA. Electronic address: skales@hsph.harvard.edu.
⁸ Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Environmental Health, Harvard School of Public Health, Boston, MA; Section of Endocrinology, Boston VA Healthcare System, Boston, MA.

PMID: 24726813
PMCID: PMC4104665
DOI: 10.1016/j.metabol.2014.03.008

Comparative Study

Circulating alanine transaminase (ALT) and γ-glutamyl transferase (GGT), but not fetuin-A, are associated with metabolic risk factors, at baseline and at two-year follow-up: the prospective Cyprus Metabolism Study

Xiaowen Liu et al. Metabolism. 2014 Jun.

. 2014 Jun;63(6):773-82.

doi: 10.1016/j.metabol.2014.03.008. Epub 2014 Mar 15.

Authors

Xiaowen Liu¹, Ole-Petter R Hamnvik², John P Chamberland³, Michael Petrou⁴, Huizhi Gong¹, Costas A Christophi⁵, David C Christiani⁶, Stefanos N Kales⁷, Christos S Mantzoros⁸

Affiliations

¹ Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA.
² Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
³ Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; Section of Endocrinology, Boston VA Healthcare System, Boston, MA.
⁴ Cyprus International Institute for Environmental and Public Health in association with Harvard School of Public Health, Cyprus University of Technology, Limassol, Cyprus.
⁵ Cyprus International Institute for Environmental and Public Health in association with Harvard School of Public Health, Cyprus University of Technology, Limassol, Cyprus; Department of Environmental Health, Harvard School of Public Health, Boston, MA.
⁶ Department of Environmental Health, Harvard School of Public Health, Boston, MA.
⁷ Department of Environmental Health, Harvard School of Public Health, Boston, MA. Electronic address: skales@hsph.harvard.edu.
⁸ Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA; Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA; Department of Environmental Health, Harvard School of Public Health, Boston, MA; Section of Endocrinology, Boston VA Healthcare System, Boston, MA.

PMID: 24726813
PMCID: PMC4104665
DOI: 10.1016/j.metabol.2014.03.008

Abstract

Objective: To comparatively evaluate traditional liver tests and fetuin A as predictors of cardiometabolic risk, we studied associations between serum alanine transaminase (ALT), γ-glutamyl transferase (GGT), aspartate aminotransferase (AST) and fetuin-A and anthropometric, metabolic, and cardiovascular parameters cross-sectionally at baseline, and prospectively, after 2-years of follow-up.

Research design and methods: 616 randomly enrolled young healthy participants in the Cyprus Metabolism Study, including all 93 subjects who participated in the follow-up study 2 years after baseline assessment, were included in this study.

Results: In the cross-sectional study, serum ALT and GGT were strongly correlated with anthropometric, cardiovascular, and metabolic variables, while serum AST was only correlated with waist circumference and waist-to-hip ratio. Fetuin-A was correlated with anthropometric variables, systolic blood pressure (SBP), insulin, and homeostasis model of assessment-insulin resistance (HOMA-IR) in the unadjusted model. In the fully adjusted model, both serum ALT and GGT levels remained positively correlated with total and low-density lipoprotein (LDL) cholesterol. GGT levels also remained correlated with triglycerides. ALT levels remained strongly positively correlated with insulin (r=0.17, p<.0001) and HOMA-IR (r=0.16, p=0.0001). Serum fetuin-A levels were no longer significantly correlated with any variables. Prospectively, ALT and GGT were predictors of anthropometric variables and LDL cholesterol, while baseline levels of AST and fetuin-A were not predictors of any variables at 2-year follow-up.

Conclusions: We confirmed associations of ALT and GGT levels but failed to demonstrate an independent association between fetuin-A and cardiometabolic risk factors in young healthy men. Traditional liver tests (LFTs) are thus better than fetuin-A predictors of metabolic risk factors cross-sectionally and prospectively in young healthy adults.

Keywords: Insulin resistance; Metabolic syndrome; Obesity.

PubMed Disclaimer

Conflict of interest statement

Disclosure

The authors have no relevant conflict of interests.

Cited by

Comparability of four clinical laboratory measurement methods for GGT and commutability of candidate reference materials.
Zhang R, Wang Q. Zhang R, et al. J Clin Lab Anal. 2020 Dec;34(12):e23557. doi: 10.1002/jcla.23557. Epub 2020 Sep 11. J Clin Lab Anal. 2020. PMID: 32914473 Free PMC article.
Treatment effect of a flavonoid prescription on duck virus hepatitis by its hepatoprotective and antioxidative ability.
Chen Y, Zeng L, Lu Y, Yang Y, Xu M, Wang Y, Liu J. Chen Y, et al. Pharm Biol. 2017 Dec;55(1):198-205. doi: 10.1080/13880209.2016.1255977. Pharm Biol. 2017. PMID: 27927057 Free PMC article.
Physical activity and elevated liver enzymes: A cross-sectional study from the PERSIAN Guilan cohort study.
Balou HA, Joukar F, Shahdkar M, Orang Goorabzarmakhi M, Maroufizadeh S, Mansour-Ghanaei F. Balou HA, et al. Caspian J Intern Med. 2025 Mar 11;16(2):246-254. doi: 10.22088/cjim.16.2.246. eCollection 2025 Spring. Caspian J Intern Med. 2025. PMID: 40575758 Free PMC article.
High-normal liver enzyme levels in early pregnancy predispose the risk of gestational hypertension and preeclampsia: A prospective cohort study.
Zhang Y, Sheng C, Wang D, Chen X, Jiang Y, Dou Y, Wang Y, Li M, Chen H, He W, Yan W, Huang G. Zhang Y, et al. Front Cardiovasc Med. 2022 Sep 12;9:963957. doi: 10.3389/fcvm.2022.963957. eCollection 2022. Front Cardiovasc Med. 2022. PMID: 36172586 Free PMC article.
Higher serum alanine aminotransferase levels and the incidence of hypertension: The Kailuan cohort study.
Jia J, Yang Y, Liu F, Chen S, Deng Y, Guo T, Peng Z, Wang X, Ma X, Wu S. Jia J, et al. Am J Prev Cardiol. 2024 Mar 3;17:100644. doi: 10.1016/j.ajpc.2024.100644. eCollection 2024 Mar. Am J Prev Cardiol. 2024. PMID: 38586187 Free PMC article.

See all "Cited by" articles

References

1. Brown CD, Higgins M, Donato KA, et al. Body mass index and the prevalence of hypertension and dyslipidemia. Obes Res. 2000;8(9):605–19. - PubMed
1. Colditz GA, Willett WC, Stampfer MJ, et al. Weight as a risk factor for clinical diabetes in women. Am J Epidemiol. 1990;132(3):501–13. - PubMed
1. Wilson PW, D’Agostino RB, Sullivan L, et al. Overweight and obesity as determinants of cardiovascular risk: The framingham experience. Arch Intern Med. 2002;162(16):1867–72. - PubMed
1. Marchesini G, Brizi M, Bianchi G, et al. Nonalcoholic fatty liver disease: A feature of the metabolic syndrome. Diabetes. 2001;50(8):1844–50. - PubMed
1. Marchesini G, Avagnina S, Barantani EG, et al. Aminotransferase and gamma-glutamyltranspeptidase levels in obesity are associated with insulin resistance and the metabolic syndrome. J Endocrinol Invest. 2005;28(4):333–9. - PubMed

Publication types

Actions
Actions
Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Substances

Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
Other Literature Sources
- scite Smart Citations
Miscellaneous
- NCI CPTAC Assay Portal

[1] Brown CD, Higgins M, Donato KA, et al. Body mass index and the prevalence of hypertension and dyslipidemia. Obes Res. 2000;8(9):605–19. - PubMed

[2] Brown CD, Higgins M, Donato KA, et al. Body mass index and the prevalence of hypertension and dyslipidemia. Obes Res. 2000;8(9):605–19. - PubMed

[3] Colditz GA, Willett WC, Stampfer MJ, et al. Weight as a risk factor for clinical diabetes in women. Am J Epidemiol. 1990;132(3):501–13. - PubMed

[4] Colditz GA, Willett WC, Stampfer MJ, et al. Weight as a risk factor for clinical diabetes in women. Am J Epidemiol. 1990;132(3):501–13. - PubMed

[5] Wilson PW, D’Agostino RB, Sullivan L, et al. Overweight and obesity as determinants of cardiovascular risk: The framingham experience. Arch Intern Med. 2002;162(16):1867–72. - PubMed

[6] Wilson PW, D’Agostino RB, Sullivan L, et al. Overweight and obesity as determinants of cardiovascular risk: The framingham experience. Arch Intern Med. 2002;162(16):1867–72. - PubMed

[7] Marchesini G, Brizi M, Bianchi G, et al. Nonalcoholic fatty liver disease: A feature of the metabolic syndrome. Diabetes. 2001;50(8):1844–50. - PubMed

[8] Marchesini G, Brizi M, Bianchi G, et al. Nonalcoholic fatty liver disease: A feature of the metabolic syndrome. Diabetes. 2001;50(8):1844–50. - PubMed

[9] Marchesini G, Avagnina S, Barantani EG, et al. Aminotransferase and gamma-glutamyltranspeptidase levels in obesity are associated with insulin resistance and the metabolic syndrome. J Endocrinol Invest. 2005;28(4):333–9. - PubMed

[10] Marchesini G, Avagnina S, Barantani EG, et al. Aminotransferase and gamma-glutamyltranspeptidase levels in obesity are associated with insulin resistance and the metabolic syndrome. J Endocrinol Invest. 2005;28(4):333–9. - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Circulating alanine transaminase (ALT) and γ-glutamyl transferase (GGT), but not fetuin-A, are associated with metabolic risk factors, at baseline and at two-year follow-up: the prospective Cyprus Metabolism Study

Affiliations

Circulating alanine transaminase (ALT) and γ-glutamyl transferase (GGT), but not fetuin-A, are associated with metabolic risk factors, at baseline and at two-year follow-up: the prospective Cyprus Metabolism Study

Authors

Affiliations

Abstract

Conflict of interest statement

Similar articles

Cited by

References

Publication types

MeSH terms

Substances

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Miscellaneous