Brief Article
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Nov 28, 2009; 15(44): 5598-5603
Published online Nov 28, 2009. doi: 10.3748/wjg.15.5598
A better parameter in predicting insulin resistance: Obesity plus elevated alanine aminotransferase
Ping-Hao Chen, Jong-Dar Chen, Yu-Cheng Lin
Ping-Hao Chen, Department of family practice, Lo-Sheng Sanatorium, Department of Health, Taipei County 242, Taiwan, China
Jong-Dar Chen, Department of family medicine, Shin Kong Wu Ho-Su Memorial Hospital, Taipei 111, Taiwan, China
Yu-Cheng Lin, Department of Occupational Medicine, Tao-Yuan General Hospital, Department of Health, Tao-Yuan 330, Taiwan, China
Author contributions: Chen PH and Lin YC were equally involved in this study; Lin YC designed the project; Chen JD collected and analyzed the data; Chen PH was involved in interpretation, revision of the article and the final approval of the manuscript for submission.
Correspondence to: Yu-Cheng Lin, MD, Department of Occupational Medicine, Tao-Yuan General Hospital, Department of Health, 14F, No. 1492, Zhong-Shan Road, Tao-Yuan 330, Taiwan, China. gphinx@gmail.com
Telephone: +886-3-3699721-2415 Fax: +886-3-3799657
Received: July 11, 2009
Revised: September 7, 2009
Accepted: September 14, 2009
Published online: November 28, 2009
Abstract

AIM: To investigate the association of obesity and elevated alanine aminotransferase with insulin resistance and compare these factors with metabolic syndrome.

METHODS: We enrolled a total of 1308 male workers aged from 22 to 63 years. Data was extracted from the workers’ periodic health check-ups in hospitals. All cases were from the community of northern Taiwan. This was a cross-sectional observational study from July to September in 2004. We grouped all cases into four groups, based on the quartile of homeostasis model assessment. The top fourth quartile group was defined as the group with insulin resistance. We performed multivariate logistic regression analysis for the odds ratio of the risk factors for insulin resistance.

RESULTS: Compared with metabolic syndrome, the coexistence of both factors had a 4.3-fold (95% CI: 2.7-6.8) increased risk, which was more than metabolic syndrome with a 3.6-fold (95% CI: 2.6-5.0) increased risk. The two factors had a synergistic effect. The synergistic index of obesity and elevated alanine aminotransferase (ALT) was 2.1 (95% CI: 1.01-4.3).

CONCLUSION: Obesity and elevated ALT are associated with insulin resistance. The effects are synergistic. Coexistence of them is better than metabolic syndrome in predicting insulin resistance.

Keywords: Alanine aminotransferase; Transaminase; Overweight; Obesity; Insulin resistance