Liver Enzyme and Adipocytokine Profiles are Synergistically Associated with Insulin Resistance: the J-SHIPP Study
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- Uetani Eri
- Department of Geriatric Medicine, Ehime University Graduate School of Medicine. Department of Geriatric Medicine, Ehime University Graduate School of Medicine.
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- Tabara Yasuharu
- Translational Research Center, Ehime University Hospital. Division of Anti-aging and Genetics, Ehime University Proteo-Medicine Research Center. Translational Research Center, Ehime University Hospital. Division of Anti-aging and Genetics, Ehime University Proteo-Medicine Research Center.
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- Igase Michiya
- Department of Geriatric Medicine, Ehime University Graduate School of Medicine. Department of Geriatric Medicine, Ehime University Graduate School of Medicine.
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- Kido Tomoko
- Department of Geriatric Medicine, Ehime University Graduate School of Medicine. Department of Geriatric Medicine, Ehime University Graduate School of Medicine.
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- Ochi Namiko
- Department of Geriatric Medicine, Ehime University Graduate School of Medicine. Department of Geriatric Medicine, Ehime University Graduate School of Medicine.
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- Takita Rie
- Department of Geriatric Medicine, Ehime University Graduate School of Medicine. Department of Geriatric Medicine, Ehime University Graduate School of Medicine.
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- Kohara Katsuhiko
- Department of Geriatric Medicine, Ehime University Graduate School of Medicine. Division of Anti-aging and Genetics, Ehime University Proteo-Medicine Research Center. Department of Geriatric Medicine, Ehime University Graduate School of Medicine. Division of Anti-aging and Genetics, Ehime University Proteo-Medicine Research Center.
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- Miki Tetsuro
- Department of Geriatric Medicine, Ehime University Graduate School of Medicine. Division of Anti-aging and Genetics, Ehime University Proteo-Medicine Research Center. Department of Geriatric Medicine, Ehime University Graduate School of Medicine. Division of Anti-aging and Genetics, Ehime University Proteo-Medicine Research Center.
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Aim: Alanine aminotransferase (ALT) and γ-glutamyltransferase (GGT) are associated with insulin resistance and arteriosclerotic disease. Since adiposity raises liver enzyme levels and causes insulin resistance, adipocytokines are thought to underlie the relationship between liver enzymes and insulin resistance. To clarify this hypothesis, we conducted a cross-sectional epidemiological study in a Japanese general population.<BR>Methods: The study subjects were 903 middle-aged to elderly persons. Plasma levels of adiponectin and leptin were measured, while other clinical parameters were obtained from personal health records of medical check-ups. Insulin resistance was assessed by a homeostasis model assessment index (HOMA-IR).<BR>Results: Plasma levels of ALT (r=0.379, p<0.001), GGT (r=0.225, p<0.001), adiponectin (r= −0.346, p<0.001) and leptin (r=0.369, p<0.001) were significantly correlated with insulin resistance even on subgroup analysis by sex. Further, any combination of liver enzymes and adipocytokines was synergistically associated with insulin resistance (p<0.001) after adjustment for possible covariates (ALT*adiponectin: β=−0.098, p<0.001, ALT*leptin: β=0.129, p<0.001, GGT*adiponectin: β=−0.054, p=0.054, GGT*leptin: β=0.126, p<0.001); however, in simple obese subjects with normal adipocytokine levels, liver enzymes were not associated with insulin resistance (mean HOMA-IR: worsened adipocytokine +/visceral obesity +, 2.01±1.14; +/−, 1.39±0.84; −/+, 1.23± 0.55; −/−, 1.03±0.57; p<0.001).<BR>Conclusion: Plasma levels of ALT and GGT were independent determinants of insulin resistance only in subjects with a worsened adipocytokine profile. Use of liver enzyme levels as a marker of insulin resistance requires stratification by adipocytokine profile.
収録刊行物
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- Ｊｏｕｒｎａｌ ｏｆ Ａｔｈｅｒｏｓｃｌｅｒｏｓｉｓ ａｎｄ Ｔｈｒｏｍｂｏｓｉｓ
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Ｊｏｕｒｎａｌ ｏｆ Ａｔｈｅｒｏｓｃｌｅｒｏｓｉｓ ａｎｄ Ｔｈｒｏｍｂｏｓｉｓ 19 (6), 577-584, 2012
一般社団法人 日本動脈硬化学会