Modifiable clinical and lifestyle factors are associated with elevated alanine aminotransferase levels in newly diagnosed type 2 diabetes patients: results from the nationwide DD2 study

Anil Mor, Elisabeth Svensson, Jørgen Rungby, Sinna Pilgaard Ulrichsen, Klara Berencsi, Jens Steen Nielsen, Jacob Volmer Stidsen, Søren Friborg, Ivan Brandslund, Jens Sandahl Christiansen, Henning Beck-Nielsen, Henrik Toft Sørensen, Reimar Wernich Thomsen

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Resumé

BACKGROUND: Current literature lacks data on markers of non-alcoholic fatty liver disease (NAFLD) in newly diagnosed type 2 diabetes mellitus (T2DM) patients. We therefore, conducted a cross-sectional study to examine modifiable clinical and lifestyle factors associated with elevated alanine aminotransferase (ALT) levels as a marker of NAFLD in new T2DM patients.

METHODS: Alanine aminotransferase levels were measured in 1026 incident T2DM patients enrolled in the nationwide Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort. We examined prevalence of elevated ALT (>38 IU/L for women and >50 IU/L for men) and calculated prevalence ratios associated with clinical and lifestyle factors using Poisson regression. We examined the association with other biomarkers by linear regression.

RESULTS: The median value of ALT was 24 IU/L (interquartile range: 18-32 IU/L) in women and 30 IU/L (interquartile range: 22-41 IU/L) in men. Elevated ALT was found in 16% of incident T2DM patients. The risk of elevated ALT was increased in patients who were <40 years old at diabetes debut [adjusted prevalence ratio (aPR): 1.96, 95% confidence interval (CI): 1.15-3.33], in those with alcohol overuse (>14/>21 drinks per week for women/men) (aPR: 1.60, 95% CI: 1.03-2.50), and in those with no regular physical activity (aPR: 1.42, 95% CI: 1.04-1.93). Obesity and metabolic syndrome per se showed no association with elevated ALT when adjusted for other markers, whereas we found positive associations of ALT with increased C-peptide (β = 0.14, 95% CI: 0.06-0.21) and fasting blood glucose (β = 0.07, 95% CI: 0.03-0.11).

CONCLUSIONS: Among newly diagnosed T2DM patients, several modifiable clinical and lifestyle factors are independent markers of elevated ALT levels. Copyright © 2014 John Wiley & Sons, Ltd.

OriginalsprogEngelsk
TidsskriftDiabetes - Metabolism: Research and Reviews (Print Edition)
Vol/bind30
Udgave nummer8
Sider (fra-til)707-15
ISSN1520-7552
DOI
StatusUdgivet - nov. 2014

Fingeraftryk

Medical problems
Alanine Transaminase
Type 2 Diabetes Mellitus
Liver
Association reactions
C-Peptide
Biomarkers
Nuclear Family
Linear regression
Blood Glucose
Linear Models
Fasting
Cross-Sectional Studies
Exercise
Research

Citer dette

Mor, Anil ; Svensson, Elisabeth ; Rungby, Jørgen ; Ulrichsen, Sinna Pilgaard ; Berencsi, Klara ; Nielsen, Jens Steen ; Stidsen, Jacob Volmer ; Friborg, Søren ; Brandslund, Ivan ; Christiansen, Jens Sandahl ; Beck-Nielsen, Henning ; Sørensen, Henrik Toft ; Thomsen, Reimar Wernich. / Modifiable clinical and lifestyle factors are associated with elevated alanine aminotransferase levels in newly diagnosed type 2 diabetes patients : results from the nationwide DD2 study. I: Diabetes - Metabolism: Research and Reviews (Print Edition). 2014 ; Bind 30, Nr. 8. s. 707-15.
@article{cd7262f49ca64d82abe37ad08d19b366,
title = "Modifiable clinical and lifestyle factors are associated with elevated alanine aminotransferase levels in newly diagnosed type 2 diabetes patients: results from the nationwide DD2 study",
abstract = "BACKGROUND: Current literature lacks data on markers of non-alcoholic fatty liver disease (NAFLD) in newly diagnosed type 2 diabetes mellitus (T2DM) patients. We therefore, conducted a cross-sectional study to examine modifiable clinical and lifestyle factors associated with elevated alanine aminotransferase (ALT) levels as a marker of NAFLD in new T2DM patients.METHODS: Alanine aminotransferase levels were measured in 1026 incident T2DM patients enrolled in the nationwide Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort. We examined prevalence of elevated ALT (>38 IU/L for women and >50 IU/L for men) and calculated prevalence ratios associated with clinical and lifestyle factors using Poisson regression. We examined the association with other biomarkers by linear regression.RESULTS: The median value of ALT was 24 IU/L (interquartile range: 18-32 IU/L) in women and 30 IU/L (interquartile range: 22-41 IU/L) in men. Elevated ALT was found in 16{\%} of incident T2DM patients. The risk of elevated ALT was increased in patients who were <40 years old at diabetes debut [adjusted prevalence ratio (aPR): 1.96, 95{\%} confidence interval (CI): 1.15-3.33], in those with alcohol overuse (>14/>21 drinks per week for women/men) (aPR: 1.60, 95{\%} CI: 1.03-2.50), and in those with no regular physical activity (aPR: 1.42, 95{\%} CI: 1.04-1.93). Obesity and metabolic syndrome per se showed no association with elevated ALT when adjusted for other markers, whereas we found positive associations of ALT with increased C-peptide (β = 0.14, 95{\%} CI: 0.06-0.21) and fasting blood glucose (β = 0.07, 95{\%} CI: 0.03-0.11).CONCLUSIONS: Among newly diagnosed T2DM patients, several modifiable clinical and lifestyle factors are independent markers of elevated ALT levels. Copyright {\circledC} 2014 John Wiley & Sons, Ltd.",
author = "Anil Mor and Elisabeth Svensson and J{\o}rgen Rungby and Ulrichsen, {Sinna Pilgaard} and Klara Berencsi and Nielsen, {Jens Steen} and Stidsen, {Jacob Volmer} and S{\o}ren Friborg and Ivan Brandslund and Christiansen, {Jens Sandahl} and Henning Beck-Nielsen and S{\o}rensen, {Henrik Toft} and Thomsen, {Reimar Wernich}",
note = "Copyright {\circledC} 2014 John Wiley & Sons, Ltd.",
year = "2014",
month = "11",
doi = "10.1002/dmrr.2539",
language = "English",
volume = "30",
pages = "707--15",
journal = "Diabetes - Metabolism: Research and Reviews (Print Edition)",
issn = "1520-7552",
publisher = "John Wiley & Sons Ltd",
number = "8",

}

Modifiable clinical and lifestyle factors are associated with elevated alanine aminotransferase levels in newly diagnosed type 2 diabetes patients : results from the nationwide DD2 study. / Mor, Anil; Svensson, Elisabeth; Rungby, Jørgen; Ulrichsen, Sinna Pilgaard; Berencsi, Klara; Nielsen, Jens Steen; Stidsen, Jacob Volmer; Friborg, Søren; Brandslund, Ivan; Christiansen, Jens Sandahl; Beck-Nielsen, Henning; Sørensen, Henrik Toft; Thomsen, Reimar Wernich.

I: Diabetes - Metabolism: Research and Reviews (Print Edition), Bind 30, Nr. 8, 11.2014, s. 707-15.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Modifiable clinical and lifestyle factors are associated with elevated alanine aminotransferase levels in newly diagnosed type 2 diabetes patients

T2 - results from the nationwide DD2 study

AU - Mor, Anil

AU - Svensson, Elisabeth

AU - Rungby, Jørgen

AU - Ulrichsen, Sinna Pilgaard

AU - Berencsi, Klara

AU - Nielsen, Jens Steen

AU - Stidsen, Jacob Volmer

AU - Friborg, Søren

AU - Brandslund, Ivan

AU - Christiansen, Jens Sandahl

AU - Beck-Nielsen, Henning

AU - Sørensen, Henrik Toft

AU - Thomsen, Reimar Wernich

N1 - Copyright © 2014 John Wiley & Sons, Ltd.

PY - 2014/11

Y1 - 2014/11

N2 - BACKGROUND: Current literature lacks data on markers of non-alcoholic fatty liver disease (NAFLD) in newly diagnosed type 2 diabetes mellitus (T2DM) patients. We therefore, conducted a cross-sectional study to examine modifiable clinical and lifestyle factors associated with elevated alanine aminotransferase (ALT) levels as a marker of NAFLD in new T2DM patients.METHODS: Alanine aminotransferase levels were measured in 1026 incident T2DM patients enrolled in the nationwide Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort. We examined prevalence of elevated ALT (>38 IU/L for women and >50 IU/L for men) and calculated prevalence ratios associated with clinical and lifestyle factors using Poisson regression. We examined the association with other biomarkers by linear regression.RESULTS: The median value of ALT was 24 IU/L (interquartile range: 18-32 IU/L) in women and 30 IU/L (interquartile range: 22-41 IU/L) in men. Elevated ALT was found in 16% of incident T2DM patients. The risk of elevated ALT was increased in patients who were <40 years old at diabetes debut [adjusted prevalence ratio (aPR): 1.96, 95% confidence interval (CI): 1.15-3.33], in those with alcohol overuse (>14/>21 drinks per week for women/men) (aPR: 1.60, 95% CI: 1.03-2.50), and in those with no regular physical activity (aPR: 1.42, 95% CI: 1.04-1.93). Obesity and metabolic syndrome per se showed no association with elevated ALT when adjusted for other markers, whereas we found positive associations of ALT with increased C-peptide (β = 0.14, 95% CI: 0.06-0.21) and fasting blood glucose (β = 0.07, 95% CI: 0.03-0.11).CONCLUSIONS: Among newly diagnosed T2DM patients, several modifiable clinical and lifestyle factors are independent markers of elevated ALT levels. Copyright © 2014 John Wiley & Sons, Ltd.

AB - BACKGROUND: Current literature lacks data on markers of non-alcoholic fatty liver disease (NAFLD) in newly diagnosed type 2 diabetes mellitus (T2DM) patients. We therefore, conducted a cross-sectional study to examine modifiable clinical and lifestyle factors associated with elevated alanine aminotransferase (ALT) levels as a marker of NAFLD in new T2DM patients.METHODS: Alanine aminotransferase levels were measured in 1026 incident T2DM patients enrolled in the nationwide Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort. We examined prevalence of elevated ALT (>38 IU/L for women and >50 IU/L for men) and calculated prevalence ratios associated with clinical and lifestyle factors using Poisson regression. We examined the association with other biomarkers by linear regression.RESULTS: The median value of ALT was 24 IU/L (interquartile range: 18-32 IU/L) in women and 30 IU/L (interquartile range: 22-41 IU/L) in men. Elevated ALT was found in 16% of incident T2DM patients. The risk of elevated ALT was increased in patients who were <40 years old at diabetes debut [adjusted prevalence ratio (aPR): 1.96, 95% confidence interval (CI): 1.15-3.33], in those with alcohol overuse (>14/>21 drinks per week for women/men) (aPR: 1.60, 95% CI: 1.03-2.50), and in those with no regular physical activity (aPR: 1.42, 95% CI: 1.04-1.93). Obesity and metabolic syndrome per se showed no association with elevated ALT when adjusted for other markers, whereas we found positive associations of ALT with increased C-peptide (β = 0.14, 95% CI: 0.06-0.21) and fasting blood glucose (β = 0.07, 95% CI: 0.03-0.11).CONCLUSIONS: Among newly diagnosed T2DM patients, several modifiable clinical and lifestyle factors are independent markers of elevated ALT levels. Copyright © 2014 John Wiley & Sons, Ltd.

U2 - 10.1002/dmrr.2539

DO - 10.1002/dmrr.2539

M3 - Journal article

C2 - 24639417

VL - 30

SP - 707

EP - 715

JO - Diabetes - Metabolism: Research and Reviews (Print Edition)

JF - Diabetes - Metabolism: Research and Reviews (Print Edition)

SN - 1520-7552

IS - 8

ER -