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Title: Circulating alanine transaminase (ALT) and γ-glutamyl transferase (GGT), but not fetuin-A, are associated with metabolic risk factors, at baseline and at two-year follow-up: The prospective Cyprus Metabolism Study
Authors: Liu, Xiaowen 
Hamnvik, Ole Petter Riksfjord 
Chamberland, John P. 
Petrou, Michael 
Gong, Huizhi 
Christophi, Costas A. 
Christiani, David C. 
Kales, Stefanos N. 
Mantzoros, Christos S. 
Keywords: Insulin resistance
Metabolic syndrome
Issue Date: 1-Jan-2014
Publisher: W.B. Saunders
Source: Metabolism: Clinical and Experimental Volume 63, Issue 6, June 2014, Pages 773-782
Abstract: Objective To comparatively evaluate traditional liver tests and fetuin A as predictors of cardiometabolic risk, we studied associations between serum alanine transaminase (ALT), γ-glutamyl transferase (GGT), aspartate aminotransferase (AST) and fetuin-A and anthropometric, metabolic, and cardiovascular parameters cross-sectionally at baseline, and prospectively, after 2-years of follow-up. Research Design and Methods 616 randomly enrolled young healthy participants in the Cyprus Metabolism Study, including all 93 subjects who participated in the follow-up study 2 years after baseline assessment, were included in this study. Results In the cross-sectional study, serum ALT and GGT were strongly correlated with anthropometric, cardiovascular, and metabolic variables, while serum AST was only correlated with waist circumference and waist-to-hip ratio. Fetuin-A was correlated with anthropometric variables, systolic blood pressure (SBP), insulin, and homeostasis model of assessment-insulin resistance (HOMA-IR) in the unadjusted model. In the fully adjusted model, both serum ALT and GGT levels remained positively correlated with total and low-density lipoprotein (LDL) cholesterol. GGT levels also remained correlated with triglycerides. ALT levels remained strongly positively correlated with insulin (r = 0.17, p <.0001) and HOMA-IR (r = 0.16, p = 0.0001). Serum fetuin-A levels were no longer significantly correlated with any variables. Prospectively, ALT and GGT were predictors of anthropometric variables and LDL cholesterol, while baseline levels of AST and fetuin-A were not predictors of any variables at 2-year follow-up. Conclusions We confirmed associations of ALT and GGT levels but failed to demonstrate an independent association between fetuin-A and cardiometabolic risk factors in young healthy men. Traditional liver tests (LFTs) are thus better than fetuin-A predictors of metabolic risk factors cross-sectionally and prospectively in young healthy adults.
ISSN: 00260495
Rights: © 2014 Elsevier B.V. All rights reserved.
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