ORs (95% CIs) of T2D associated with different levels of liver enzymes, the SCHS
| Variables | Tertiles of liver enzymes | p for trend* | ||
|---|---|---|---|---|
| T1 | T2 | T3 | ||
| Whole dataset | ||||
| ALT | ||||
| Median (range) | 14 (6–17) | 21 (18–24) | 33 (25–130) | |
| Cases/controls | 93/218 | 152/163 | 326/190 | |
| Model 1 | 1.00 | 1.98 (1.34–2.92) | 3.73 (2.56–5.44) | <0.001 |
| Model 2 | 1.00 | 1.56 (1.02–2.40) | 2.33 (1.52–3.55) | <0.001 |
| AST | ||||
| Median (range) | 20 (12–22) | 25 (23–27) | 33 (28–135) | |
| Cases/controls | 173/212 | 153/181 | 245/178 | |
| Model 1 | 1.00 | 0.96 (0.69–1.33) | 1.39 (1.01–1.91) | 0.03 |
| Model 2 | 1.00 | 0.90 (0.63–1.30) | 1.10 (0.77–1.58) | 0.52 |
| ALP | ||||
| Median (range) | 61 (23–70) | 78 (71–86) | 101 (87–401) | |
| Cases/controls | 155/191 | 168/194 | 248/186 | |
| Model 1 | 1.00 | 1.14 (0.82–1.58) | 1.78 (1.28–2.48) | <0.001 |
| Model 2 | 1.00 | 1.08 (0.74–1.56) | 1.39 (0.96–2.02) | 0.07 |
| LDH | ||||
| Median (range) | 331 (216–366) | 394 (367–426) | 473 (427–713) | |
| Cases/controls | 205/191 | 191/191 | 175/189 | |
| Model 1 | 1.00 | 0.85 (0.60–1.20) | 0.71 (0.50–1.01) | 0.06 |
| Model 2 | 1.00 | 0.77 (0.52–1.13) | 0.72 (0.49–1.07) | 0.12 |
| Limited to cases with baseline HbA1c <48 mmol/mol (6.5%) and their matched controls | ||||
| GGT† | ||||
| Median (range) | 15 (10–18) | 24 (19–28) | 43 (29–741) | |
| Cases/controls | 48/92 | 70/80 | 137/83 | |
| Model 1 | 1.00 | 1.53 (0.81–2.87) | 2.91 (1.61–5.26) | <0.001 |
| Model 2 | 1.00 | 1.28 (0.61–2.68) | 2.00 (1.01–3.96) | 0.03 |
| ALT | ||||
| Median (range) | 14 (6–16) | 20 (17–23) | 33 (24–119) | |
| Cases/controls | 45/98 | 85/98 | 162/96 | |
| Model 1 | 1.00 | 2.08 (1.15–3.74) | 3.85 (2.15–6.90) | <0.001 |
| Model 2 | 1.00 | 1.84 (0.94–3.59) | 2.38 (1.21–4.66) | 0.05 |
| AST | ||||
| Median (range) | 20 (13–22) | 25 (23–27) | 33 (28–105) | |
| Cases/controls | 93/104 | 82/104 | 117/84 | |
| Model 1 | 1.00 | 0.84 (0.51–1.37) | 1.38 (0.86–1.37) | 0.12 |
| Model 2 | 1.00 | 0.75 (0.43–1.30) | 1.03 (0.60–1.77) | 0.80 |
| ALP | ||||
| Median (range) | 60 (28–70) | 78 (71–86) | 101 (87–172) | |
| Cases/controls | 90/101 | 90/94 | 112/97 | |
| Model 1 | 1.00 | 1.01 (0.65–1.59) | 1.33 (0.84–2.10) | 0.21 |
| Model 2 | 1.00 | 0.94 (0.56–1.57) | 0.92 (0.53–1.59) | 0.76 |
| LDH | ||||
| Median (range) | 330 (216–363) | 392 (364–425) | 472 (427–687) | |
| Cases/controls | 107/98 | 107/98 | 78/96 | |
| Model 1 | 1.00 | 1.03 (0.62–1.70) | 0.67 (0.62–1.70) | 0.06 |
| Model 2 | 1.00 | 0.94 (0.52–1.68) | 0.68 (0.37–1.24) | 0.13 |
ORs of liver enzymes in the whole dataset and among cases with baseline HbA1c <48 mmol/mol (6.5%) and their matched controls were computed using conditional logistic regression models with adjustment for following covariates.
Model 1: adjusted for age at blood taken (continuous), smoking (never, past, and current smoker), alcohol intake (never, weekly, or daily), weekly moderate-to-vigorous activity (<0.5, 0.5–3, and ≥4 hours/week), education level (no, primary school, secondary or above), history of hypertension (yes, no), fasting status (yes, no), and BMI (continuous).
Model 2: model 1 plus adjusted triglycerides (mmol/L), high-density lipoprotein cholesterol (mmol/L), C-reactive protein (mg/L), and adiponectin (µg/mL) (all in tertiles).
*Linear trend was tested using the median level of each tertile of liver enzymes.
†GGT concentrations were measured in 510 participants (255 case–control pairs with cases having baseline HbA1c <48 mmol/mol (6.5%)).
ALP, alkaline phosphatase; ALT, alanine aminotransferase; AST, aspartate aminotransferase; BMI, body mass index; GGT, γ-glutamyl transferase; HbA1c, hemoglobin A1c; LDH, lactate dehydrogenase; SCHS, Singapore Chinese Health Study; T2D, type 2 diabetes.