RESUMEN
Objective To study the association of the serum alanine aminotransferase (ALT) level with cardiovascular risks in patients with type 2 diabetes mellitus (T2DM).Methods A total of 676 patients with T2DM who excluded liver disease due to chronic viral hepatitis,autoimmune,drugs,alcohol,and other hereditary were selected.According to the ALT level,676 patients were assigned into elevated ALT group (ALT ＞40 U/L,126 cases) and normal ALT group (ALT 5-40 U/L,550 cases).And normal ALT group were divided into 4 groups on the interquartile distance:group 1 (ALT 5-11 U/L,108 cases),group 2 (ALT 12-15 U/L,114 cases),group 3 (ALT 16-21 U/L,127 cases),group 4 (ALT 22-40 U/L,201cases).The age,duration of diabetes,body mass index (BMI),waist-to-hip ratio (WHR),blood pressure,triglyceride (TG),total cholesterol (TC),high density lipoprotein cholesferol (HDL-C),low density lipoprotein cholesferol (LDL-C),fasting plasma glucose (FPG),2 h postprandial blood glucose (2 hPG),glycosylated hemoglobin (HbA1c),uric acid (UA),fasting insulin and homeostasis model assessment insulin resistance index (HOMA-IR) was compared among these groups.Results The levels of BMI,WHR,diastolic blood pressure,FPG,2 hPG,HbA1c,fasting insulin,TG,HOMA-IR and UA in elevated ALT group were higher than those in normal ALT group [(26.80 ± 3.60) kg/m2 vs.(23.40 ± 3.50) kg/m2,0.95 ±0.05 vs.0.91 ± 0.05,(75.3 ± 9.3) mm Hg (1 mm Hg =0.133 kPa) vs.(69.2 ± 9.5)mm Hg,(9.24 ± 2.56)mmol/L vs.(8.53 ± 2.78) mmol/L,(15.25 ± 4.62) mmol/L vs.(14.37 ± 5.06) mmoUL,(8.31 ± 1.76)％ vs.(7.78 ± 1.94)％,(10.76 ± 6.78) mU/L vs.(7.85 ± 7.04) mU/L,(2.73 ± 2.40) mmol/L vs.(2.20 ± 2.78)mmol/L,4.13 ± 2.76 vs.3.06 ± 2.63,(332.42 ± 95.12) μ mol/L vs.(285.14 ± 79.53) μ mol/L] (P ＜ 0.05),and HDL-C was lower than that in normal ALT group [(1.06 ± 0.27) mmol/L vs.(1.15 ± 0.57) mmol/L] (P ＜0.05).Compared with that in normal ALT group,the age was younger,and the duration of diabetes was shorter in elevated ALT group [(49.6 ± 10.5) years vs.(57.5 ± 11.3) years,(37.9 ±42.0) months vs.(54.5 ± 57.8) months] (P ＜ 0.05).The levels of FPG,2 hPG,HbA1c and UA in group 4 were higher than those in group 1,2,3 [(9.18 ± 3.01) mmol/L vs.(8.33 ± 2.57),(8.38 ± 2.52),(8.45 ± 2.73) mmol/L;(14.56 ± 4.80) mmol/L vs.(13.15 ± 5.72),(13.42 ± 4.56),(13.50 ± 5.17) mmol/L; (7.81 ± 1.98)％ vs.(6.76 ± 1.84)％,(6.79 ± 2.10)％,(6.88 ± 2.43)％; (288.24 ± 78.26) μ mol/L vs.(271.15 ± 75.43),(273.27 ± 71.25),(275.56 ± 69.57) μ mol/L] (P ＜ 0.05) ; HOMA-IR was lower than that in group 1,2,3(2.67 ± 2.65 vs.2.84 ± 2.53,2.98 ± 3.10,3.12 ± 2.57,P ＜ 0.05).Conclusion TheincreaseofALTlevel is associated with the clustered cardiovascular risk factors and insulin resistance in patients with T2DM.