Incremental predictive value of serum AST-to-ALT ratio for incident metabolic syndrome

The ARIRANG study

Dhananjay Yadav, Eunhee Choi, Songvogue Ahn, Soonkoo Baik, Youn Zoo Cho, Sangbaek Koh, Ji Hye Huh, Yoosoo Chang, Ki Chul Sung, Jang Young Kim

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Aims: The ratio of aspartate aminotransferase (AST) to alanine aminotransferase (ALT) is of great interest as a possible novel marker of metabolic syndrome. However, longitudinal studies emphasizing the incremental predictive value of the AST-to-ALT ratio in diagnosing individuals at higher risk of developing metabolic syndrome are very scarce. Therefore, our study aimed to evaluate the AST-to-ALT ratio as an incremental predictor of new onset metabolic syndrome in a population-based cohort study. Material and Methods: The population-based cohort study included 2276 adults (903 men and 1373 women) aged 40-70 years, who participated from 2005-2008 (baseline) without metabolic syndrome and were followed up from 2008-2011. Metabolic syndrome was defined according to the harmonized definition of metabolic syndrome. Serum concentrations of AST and ALT were determined by enzymatic methods. Results: During an average follow-up period of 2.6-years, 395 individuals (17.4%) developed metabolic syndrome. In a multivariable adjusted model, the odds ratio (95% confidence interval) for new onset of metabolic syndrome, comparing the fourth quartile to the first quartile of the AST-to-ALT ratio, was 0.598 (0.422-0.853). The AST-to-ALT ratio also improved the area under the receiver operating characteristic curve (AUC) for predicting new cases of metabolic syndrome (0.715 vs. 0.732, P = 0.004). The net reclassification improvement of prediction models including the AST-to-ALT ratio was 0.23 (95% CI: 0.124-0.337, P<0.001), and the integrated discrimination improvement was 0.0094 (95% CI: 0.0046-0.0143, P<0.001). Conclusions: The AST-to-ALT ratio independently predicted the future development of metabolic syndrome and had incremental predictive value for incident metabolic syndrome.

Original languageEnglish
Article numbere0161304
JournalPloS one
Volume11
Issue number8
DOIs
Publication statusPublished - 2016 Aug 1

Fingerprint

metabolic syndrome
Aspartate Aminotransferases
Alanine Transaminase
alanine transaminase
aspartate transaminase
Serum
cohort studies
Cohort Studies
longitudinal studies
taxonomic revisions
ROC Curve
odds ratio
Population
Area Under Curve
Longitudinal Studies
confidence interval
Odds Ratio
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Yadav, Dhananjay ; Choi, Eunhee ; Ahn, Songvogue ; Baik, Soonkoo ; Cho, Youn Zoo ; Koh, Sangbaek ; Huh, Ji Hye ; Chang, Yoosoo ; Sung, Ki Chul ; Kim, Jang Young. / Incremental predictive value of serum AST-to-ALT ratio for incident metabolic syndrome : The ARIRANG study. In: PloS one. 2016 ; Vol. 11, No. 8.
@article{cb77272f34b04a95a7ae3350a3b34a55,
title = "Incremental predictive value of serum AST-to-ALT ratio for incident metabolic syndrome: The ARIRANG study",
abstract = "Aims: The ratio of aspartate aminotransferase (AST) to alanine aminotransferase (ALT) is of great interest as a possible novel marker of metabolic syndrome. However, longitudinal studies emphasizing the incremental predictive value of the AST-to-ALT ratio in diagnosing individuals at higher risk of developing metabolic syndrome are very scarce. Therefore, our study aimed to evaluate the AST-to-ALT ratio as an incremental predictor of new onset metabolic syndrome in a population-based cohort study. Material and Methods: The population-based cohort study included 2276 adults (903 men and 1373 women) aged 40-70 years, who participated from 2005-2008 (baseline) without metabolic syndrome and were followed up from 2008-2011. Metabolic syndrome was defined according to the harmonized definition of metabolic syndrome. Serum concentrations of AST and ALT were determined by enzymatic methods. Results: During an average follow-up period of 2.6-years, 395 individuals (17.4{\%}) developed metabolic syndrome. In a multivariable adjusted model, the odds ratio (95{\%} confidence interval) for new onset of metabolic syndrome, comparing the fourth quartile to the first quartile of the AST-to-ALT ratio, was 0.598 (0.422-0.853). The AST-to-ALT ratio also improved the area under the receiver operating characteristic curve (AUC) for predicting new cases of metabolic syndrome (0.715 vs. 0.732, P = 0.004). The net reclassification improvement of prediction models including the AST-to-ALT ratio was 0.23 (95{\%} CI: 0.124-0.337, P<0.001), and the integrated discrimination improvement was 0.0094 (95{\%} CI: 0.0046-0.0143, P<0.001). Conclusions: The AST-to-ALT ratio independently predicted the future development of metabolic syndrome and had incremental predictive value for incident metabolic syndrome.",
author = "Dhananjay Yadav and Eunhee Choi and Songvogue Ahn and Soonkoo Baik and Cho, {Youn Zoo} and Sangbaek Koh and Huh, {Ji Hye} and Yoosoo Chang and Sung, {Ki Chul} and Kim, {Jang Young}",
year = "2016",
month = "8",
day = "1",
doi = "10.1371/journal.pone.0161304",
language = "English",
volume = "11",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "8",

}

Incremental predictive value of serum AST-to-ALT ratio for incident metabolic syndrome : The ARIRANG study. / Yadav, Dhananjay; Choi, Eunhee; Ahn, Songvogue; Baik, Soonkoo; Cho, Youn Zoo; Koh, Sangbaek; Huh, Ji Hye; Chang, Yoosoo; Sung, Ki Chul; Kim, Jang Young.

In: PloS one, Vol. 11, No. 8, e0161304, 01.08.2016.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Incremental predictive value of serum AST-to-ALT ratio for incident metabolic syndrome

T2 - The ARIRANG study

AU - Yadav, Dhananjay

AU - Choi, Eunhee

AU - Ahn, Songvogue

AU - Baik, Soonkoo

AU - Cho, Youn Zoo

AU - Koh, Sangbaek

AU - Huh, Ji Hye

AU - Chang, Yoosoo

AU - Sung, Ki Chul

AU - Kim, Jang Young

PY - 2016/8/1

Y1 - 2016/8/1

N2 - Aims: The ratio of aspartate aminotransferase (AST) to alanine aminotransferase (ALT) is of great interest as a possible novel marker of metabolic syndrome. However, longitudinal studies emphasizing the incremental predictive value of the AST-to-ALT ratio in diagnosing individuals at higher risk of developing metabolic syndrome are very scarce. Therefore, our study aimed to evaluate the AST-to-ALT ratio as an incremental predictor of new onset metabolic syndrome in a population-based cohort study. Material and Methods: The population-based cohort study included 2276 adults (903 men and 1373 women) aged 40-70 years, who participated from 2005-2008 (baseline) without metabolic syndrome and were followed up from 2008-2011. Metabolic syndrome was defined according to the harmonized definition of metabolic syndrome. Serum concentrations of AST and ALT were determined by enzymatic methods. Results: During an average follow-up period of 2.6-years, 395 individuals (17.4%) developed metabolic syndrome. In a multivariable adjusted model, the odds ratio (95% confidence interval) for new onset of metabolic syndrome, comparing the fourth quartile to the first quartile of the AST-to-ALT ratio, was 0.598 (0.422-0.853). The AST-to-ALT ratio also improved the area under the receiver operating characteristic curve (AUC) for predicting new cases of metabolic syndrome (0.715 vs. 0.732, P = 0.004). The net reclassification improvement of prediction models including the AST-to-ALT ratio was 0.23 (95% CI: 0.124-0.337, P<0.001), and the integrated discrimination improvement was 0.0094 (95% CI: 0.0046-0.0143, P<0.001). Conclusions: The AST-to-ALT ratio independently predicted the future development of metabolic syndrome and had incremental predictive value for incident metabolic syndrome.

AB - Aims: The ratio of aspartate aminotransferase (AST) to alanine aminotransferase (ALT) is of great interest as a possible novel marker of metabolic syndrome. However, longitudinal studies emphasizing the incremental predictive value of the AST-to-ALT ratio in diagnosing individuals at higher risk of developing metabolic syndrome are very scarce. Therefore, our study aimed to evaluate the AST-to-ALT ratio as an incremental predictor of new onset metabolic syndrome in a population-based cohort study. Material and Methods: The population-based cohort study included 2276 adults (903 men and 1373 women) aged 40-70 years, who participated from 2005-2008 (baseline) without metabolic syndrome and were followed up from 2008-2011. Metabolic syndrome was defined according to the harmonized definition of metabolic syndrome. Serum concentrations of AST and ALT were determined by enzymatic methods. Results: During an average follow-up period of 2.6-years, 395 individuals (17.4%) developed metabolic syndrome. In a multivariable adjusted model, the odds ratio (95% confidence interval) for new onset of metabolic syndrome, comparing the fourth quartile to the first quartile of the AST-to-ALT ratio, was 0.598 (0.422-0.853). The AST-to-ALT ratio also improved the area under the receiver operating characteristic curve (AUC) for predicting new cases of metabolic syndrome (0.715 vs. 0.732, P = 0.004). The net reclassification improvement of prediction models including the AST-to-ALT ratio was 0.23 (95% CI: 0.124-0.337, P<0.001), and the integrated discrimination improvement was 0.0094 (95% CI: 0.0046-0.0143, P<0.001). Conclusions: The AST-to-ALT ratio independently predicted the future development of metabolic syndrome and had incremental predictive value for incident metabolic syndrome.

UR - http://www.scopus.com/inward/record.url?scp=84990032740&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84990032740&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0161304

DO - 10.1371/journal.pone.0161304

M3 - Article

VL - 11

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 8

M1 - e0161304

ER -