30Mar 2017

CORRELATION OF ALT/AST RATIO WITH INSULIN RESISTANCE IN METABOLIC SYNDROME.

  • Ramya SG-Junior Resident, Department of General Medicine, Lady Hardinge Medical College, Newdelhi.
  • Rajinder K Dhamija – Professor, Department of General Medicine, Lady Hardinge Medical College, Newdelhi.
  • Anil Gurtoo –Professor, Department of General Medicine, Lady Hardinge Medical College, Newdelhi.
  • Ritu Singh – Professor, Department of Biochemistry, Lady Hardinge Medical College, Newdelhi.
Crossref Cited-by Linking logo
  • Abstract
  • Keywords
  • References
  • Cite This Article as
  • Corresponding Author

Background:In recent years, non-alcoholic fatty liver disease is considered as a novel component of insulin resistance and metabolic syndrome, which is found to be associated with mild elevation of liver enzymes. Aim of the Study:The aim of this study was to correlate the ALT/AST ratio with insulin resistance calculated by HOMA-IR (Homeostatic model assessment-Insulin resistance) method among patients found to have metabolic syndrome. Design and Methodology: This was an observational cross sectional study which included 60 subjects of metabolic syndrome defined by International Diabetes Federation criteria. The relevant clinical examination and basic investigations were done. Fasting insulin levels were analysed by chemiluminescence method. Liver function tests were done by fully automated AnalyzerSynchron CX-9 using Roche kits, calibrators and Randox control Sera. Data was processed and analyzed by SPSS version 17.0 software. The Correlation between ALT/AST ratio and HOMA-IR was assessed using The Pearson correlation test. Results The ALT/AST Ratio was found to have positive correlation with HOMA-IR (Pearson’s correlation coefficient is +0.742 and the significance was <0.001). This study shows that ALT/AST ratio can be used as screening tool of insulin resistance in the community.

  1. Pratt DS, Kaplan MM. Evaluation of abnormal liver enzyme results in asymptomatic patients.NEngl J Med 2000; 342:1266-71.
  2. Duckworth WC, Hamel FG, Peavy DE 1988 Hepatic metabolism of insulin. Am J Med85:71-76.
  3. Michael MD, Kulkarni RN, Postic C, Previs SF, Shulman GI, Magnuson MA, Kahn CR: Loss of insulin signaling in hepatocytes leads to severe insulin resistance and progressive hepatic dysfunction. Mol Cell 6:87–97, 2000.
  4. Grundy S, Brewer B, Cleman J, Smith S, LenfantC.Definition of metabolic syndrome: Report of the National Heart,Lung,and the Blood institute/American Heart Association Conference on Scientific Issues Related to definition.Circulation 2004; 109:433-438.
  5. Chitturi S, Abeygunasekera S, Farell GC, Holmes Walker J, Hui M, Fung C, Karim R. NASH and Insulin resistance: insulin hypersecretion and specific association with the insulin resistance syndrome.Hepatology 2002; 35: 373-379.
  6. Marceau P, Biron S, Hould FS, Marceau S, Simard S,Thung SN, Kral JG. Liver pathology and Metabolic syndrome X in severe obesity. J ClinEndocrinolMetab1999; 84: 1513-1517.
  7. S Banerjee, US Ghosh, S Dutta. Clinicopathological Profile of Hepatic Involvement in Type-2 Diabetes Mellitus and Its Significance.JAPI august 2008;vol 56:594-599.
  8. Prasad DS, Kabir Z, Dash AK, Das BC. Prevalence and risk factors for metabolic syndrome in Asian Indians: A community study from urban Eastern India. J Cardiovasc Dis Res 2012; 3:204-11.
  9. Kumar SV, Nagesh A, Leena M, Shravani G, Chandrasekar V. Incidence of metabolic syndrome and its characteristics of patients attending a diabetic outpatient clinic in a tertiary care hospital. J Nat ScBiol Med 2013; 4:57-62.
  10. Deepa, M., Farooq, S., Datta, M., Deepa, R. and Mohan, V. 2007. Prevalence of metabolic syndrome using WHO, ATPIII and IDF definitions in Asian Indians: the Chennai Urban Rural Epidemiology Study (CURES-34). Diabetes/metabolism research and reviews, 23 (2), pp.127-134.
  11. Tan C., Ma, S., Wai, D., Chew, S. and Tai, E. 2004. Can we apply the National Cholesterol Education Program Adult Treatment Panel definition of the metabolic syndrome to Asians? Diabetes care, 27 (5), pp. 1182--1186.
  12. Kanjilal S, Shanker J, Rao VS, Khadrinarasimhaih NB, Mukherjee M, Iyengar SS, et al. Prevalence and component analysis of metabolic syndrome: An Indian atherosclerosis research study perspective. Vasc Health Risk Manag. 2008; 4:189–97.
  13. Garg MK, Dutta MK, Mahalle N. Study of beta-cell function (by HOMA model) in metabolic syndrome. Indian J EndocrinolMetab. 2011; 15:S44–9.
  14. Bhat RA, Laway BA, Zargar AH (2010) Prevalence of metabolic syndrome in Kashmir valley of Indian subcontinent. Indian J Med Sci 64: 259-264.
  15. Indulekha, K., Surendar, J. and Mohan, V. 2011. High sensitivity C-reactive protein, tumor necrosis factor-?, interleukin-6, and vascular cell adhesion molecule-1 levels in Asian Indians with metabolic syndrome and insulin resistance (CURES-105). Journal of diabetes science and technology, 5 (4), pp. 982--988.
  16. Hanley A, Williams K, Festa A, Wagenknecht L, D’Agostino R, Haffner S. Liver Markers and Development of the Metabolic Syndrome The Insulin Resistance Atherosclerosis Study. Diabetes. 2005; 54 (11): 3140--3147.
  17. Elizondo-Montemayor L, Ugalde-Casas PA, Lam-Franco L, Bustamante-CareagaH,Serrano-Gonzalez M, Gutiérrez NG, Martinez U. Association of ALT and the metabolic syndrome among Mexican children. Obes Res Clin Pract.2014 Jan-Feb; 8(1):e79-87.
  18. Park H, Han J, Choi K, Kim S. Relation between elevated serum alanine aminotransferase and metabolic syndrome in Korean adolescents. The American journal of clinical nutrition. 2005; 82 (5): 1046--1051.
  19. Qiang Lu, Xiaoli Liu, Shuhua Liu, ChangshunXie, Yali Liu and Chunming Ma (2012). The Relationship Between AST/ALT Ratio and Metabolic Syndrome in Han Young Adults - AST/ALT Ratio and Metabolic Syndrome, Recent Advances in Cardiovascular Risk Factors, Prof. MehnazAtiq (Ed.), ISBN: 978-953-51-0321-9, InTech, DOI: 10.5772/31633.
  20. Chen Z, Chen L, Dai H, Chen J, Fang L. Relationship between alanine aminotransferase levels and metabolic syndrome in nonalcoholic fatty liver disease. Journal of Zhejiang University Science B. 2008; 9 (8): 616--622.
  21. Chen P H, Chen J D, Lin Y C. A better parameter in predicting insulin resistance: obesity plus elevated alanine aminotransferase. World J Gastroenterol 2009, 15:5598-5603.
  22. Kawamoto R, Kohara K, Kusunoki T, Tabara Y, Abe M, Miki T, Others. Alanine aminotransferase/aspartate aminotransferase ratio is the best surrogate marker for insulin resistance in non-obese Japanese adults. CardiovascDiabetol. 2012; 11: 117.
  23. Gao F, Pan JM, Hou XH, Fang QC, Lu HJ, Tang JL, et al. Liver enzymes concentrations are closely related to prediabetes: Findings of the Shanghai Diabetes Study II (SHDS II)Biomed Environ Sci. 2012;25:30–7.
  24. Esteghamati A, Jamali A, Khalilzadeh O, Noshad S, Khalili M, Zandieh A. et al., Metabolic syndrome is linked to a mild elevation in liver aminotransferases in diabetic patients with undetectable non-alcoholic fatty liver disease by ultrasound. DiabetolMetabSyndr 2010; 2:65.
     

[Ramya SG , Rajinder K Dhamija, Anil Gurtoo and Ritu Singh. (2017); CORRELATION OF ALT/AST RATIO WITH INSULIN RESISTANCE IN METABOLIC SYNDROME. Int. J. of Adv. Res. 5 (Mar). 1677-1684] (ISSN 2320-5407). www.journalijar.com

Ramya SG

DOI:

Article DOI: 10.21474/IJAR01/3678      
DOI URL: https://dx.doi.org/10.21474/IJAR01/3678

Download Full Paper

Download PDF No. of Downloads: 70 | No. of Views: 347