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. 2024 Jun 19:11:1418364.
doi: 10.3389/fmed.2024.1418364. eCollection 2024.

The ratio of alanine aminotransferase to high-density lipoprotein cholesterol is positively correlated with the insulin resistance in American adults: a population-based cohort study

Xinhe Zhou  1 , Jing Xu  1 , Huifang Dai  1
Affiliations

The ratio of alanine aminotransferase to high-density lipoprotein cholesterol is positively correlated with the insulin resistance in American adults: a population-based cohort study

Xinhe Zhou et al. Front Med (Lausanne). .

Abstract

Introduction: Previous studies have demonstrated a correlation between the ratio of alanine aminotransferase to high-density lipoprotein cholesterol (ALT/HDL-C) in the serum and the risk of diabetes. However, no existing study has investigated the association between insulin resistance (IR) and ALT/HDL-C. Therefore, this study aims to explore the association between ALT/HDL-C and IR in American adults.

Methods: A total of 7,599 adults selected from the National Health and Nutrition Examination Survey (NHANES) in 2013 to 2020 were studied. IR was assessed based on the homeostatic model assessment of insulin resistance (HOMA-IR). And the association between IR and ALT/HDL-C was assessed through multiple logistic regression, generalized smooth curve fitting and subgroup analyses.

Results: Multiple logistic regression analysis indicated a significant correlation between IR and ALT/HDL-C, with odds ratios (OR) of 1.04 (95% CI = 1.02-1.05) in males and 1.04 (95% CI = 1.02-1.07) in females. A non-linear association and saturation effect between ALT/HDL-C and IR risk were identified, with an inverted L shaped curve and an inflection point at 33.62. The area under the ROC curve (AUC) of ALT/HDL-C was significantly larger (AUC = 0.725 for males and 0.696 for females, all p < 0.01) compared with the use of ALT, HDL-C, AST and AST/ALT. Subgroup analysis showed a significantly higher independent association in obese individuals and individuals aged ≥50 years (All P interaction <0.05).

Conclusion: Elevated ALT/HDL-C demonstrates a significant correlation with IR, which can be used as a potential indicator of IR in American adults.

Keywords: alanine aminotransferase; diabetes; insulin resistance; obesity; race.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the sample selection from the 2013–2020 NHANES.
Figure 2
Figure 2
The smooth curve fit for the association between ALT/HDL-C and prevalence of IR.
Figure 3
Figure 3
Subgroups analysis for the association between ALT/HDL-C and prevalence of IR by gender, age, race, BMI, diabetes, moderate activities, education level and drinking.
Figure 4
Figure 4
ROC analysis of ALT/HDL-C, ALT, HDL-C, AST and AST/ALT to IR among American adults.
See this image and copyright information in PMC

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References

    1. Tam CS, Xie W, Johnson WD, Cefalu WT, Redman LM, Ravussin E. Defining insulin resistance from hyperinsulinemic-euglycemic clamps. Diabetes Care. (2012) 35:1605–10. doi: 10.2337/dc11-2339, PMID: - DOI - PMC - PubMed
    1. Wallace TM, Levy JC, Matthews DR. Use and abuse of HOMA modeling. Diabetes Care. (2004) 27:1487–95. doi: 10.2337/diacare.27.6.1487 - DOI - PubMed
    1. Espinel-Bermudez MC, Robles-Cervantes JA, Del Sagrario Villarreal-Hernandez L, Villasenor-Romero JP, Hernandez-Gonzalez SO, Gonzalez-Ortiz M, et al. . Insulin resistance in adult primary care patients with a surrogate index, Guadalajara, Mexico, 2012. J Investig Med. (2015) 63:247–50. doi: 10.1097/JIM.0000000000000130, PMID: - DOI - PMC - PubMed
    1. Borai A, Livingstone C, Ferns GA. The biochemical assessment of insulin resistance. Ann Clin Biochem. (2007) 44:324–42. doi: 10.1258/000456307780945778 - DOI - PubMed
    1. Rudvik A, Mansson M. Evaluation of surrogate measures of insulin sensitivity - correlation with gold standard is not enough. BMC Med Res Methodol. (2018) 18:64. doi: 10.1186/s12874-018-0521-y, PMID: - DOI - PMC - PubMed

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