Purpose: To investigate whether the relationship between body mass index (BMI) and incident diabetes is modified by different alanine or aspartate aminotransferases (ALT or AST) levels. Methods: We carried out an analysis of 6484 participants aged 40 years or older using data from the Korean Genome Epidemiology Study. The serum aminotransferase levels were stratified into low and high groups according to the median values and classified into three groups: both low, either high, and both high. To assess the association between BMI and incident diabetes according to the serum aminotransferase levels, multiple logistic regression models were used. Results: In participants with high levels of both ALT and AST, compared with the first BMI quartile, the adjusted odds ratios for incident diabetes of the second, third, and fourth BMI quartiles were 1.72 (95% confidence interval, 0.84–3.55), 2.19 (1.11–4.33), and 3.08 (1.60–5.90), respectively (P trend <.001). In participants with either high ALT or AST, the adjusted odds ratios were 3.58 (1.23–10.41), 2.65 (0.90–7.76), and 5.28 (1.86–15.02), respectively (P trend =.005). However, in participants with both low ALT and AST levels, high BMI was not independently associated with the risk of incident diabetes. Conclusions: There was a strong association between BMI and incident diabetes among individuals with high aminotransferase levels, whereas no association was observed among those with low aminotransferase levels.
Bibliographical noteFunding Information:
The study was supported by grants from the Korea Centers for Disease Control and Prevention (2005-E71013-00, 2006-E71002-00, 2007-E71013-00, 2008-E71004-00, 2009-E71006-00, 2010-E71003-00, 2011-E71002-00, 2012-E71007-00, 2013-E71008-00, and 2014-E71006-00) and the Korean Health Technology R&D Project, Ministry of Health & Welfare (HI13C0715).
H.C.K., S.V.A., S.B.K., and I.S. designed research; J.M.L. supervised the study and acquired data; B.M.S. analyzed the data and wrote the article; H.C.K., D.J.K., S.V.A., K.M.K., and I.S. provided critical revision of the article for important intellectual content; and H.C.K. had primary responsibility for final content. All authors read and approved the final article. This work is based on the doctoral dissertation of Bo Mi Song entitled ?Liver enzymes, body mass index, and the risk of diabetes? at Yonsei University. The study was supported by grants from the Korea Centers for Disease Control and Prevention (2005-E71013-00, 2006-E71002-00, 2007-E71013-00, 2008-E71004-00, 2009-E71006-00, 2010-E71003-00, 2011-E71002-00, 2012-E71007-00, 2013-E71008-00, and 2014-E71006-00) and the Korean Health Technology R&D Project, Ministry of Health & Welfare (HI13C0715).
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