Potential role of liver enzymes for predicting elevated blood glucose levels

Abstract Background This study was to explore the potential effect of different liver enzymes on elevated blood glucose with the use of a more detailed blood glucose grouping. Methods This cross-sectional study enrolled 144,135 participants who had biochemical examinations from 2014–2018. Participants were classified by sex and different blood glucose levels (< 5.0 mmol/L, 5.0-5.5 mmol/L, 5.6–6.2 mmol/L, 6.3–6.9 mmol/L, and ≥ 7.0 mmol/L). The associations between liver function indicators and occurrence of type 2 diabetes (T2DM) were analyzed through multivariate linear regression and multiple logistic regression. Results There was a significant difference among the biochemical indices between different blood glucose groups in males and females. Liver enzymes such as alanine aminotransferase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), and γ-glutamyl transpeptidase (GGT) were independent risk factors for raised blood glucose, and there were gender differences in the predictive performance of each liver enzyme to elevated blood glucose levels. In men, GGT was the most appropriate to predict progressive elevation of blood glucose or T2DM risk, and ALT and ALP may only be applicable to the prediction of impaired fasting glucose (IFG). By contrast, ALT and ALP were the most appropriate enzymes for the prediction of the risk of elevated blood glucose or T2DM in women, and AST and GGT may only be appropriate for the prediction of IFG. Conclusions Liver enzymes were independent risk factors for elevated blood glucose. There were gender differences in the role of each liver enzyme for elevated blood glucose. GGT was more suitable as a predictor for dynastic elevated blood glucose in men, whereas for women, ALT and ALP were more suitable.