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Published online March 17, 2008
Diabetes Care 31:1138-1143, 2008
DOI: 10.2337/dc07-2159
© 2008 by the American Diabetes Association
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Epidemiology/Health Services Research
Original Research

Liver Enzymes and Incident Diabetes

Findings from the European Prospective Investigation Into Cancer and Nutrition (EPIC)-Potsdam Study

Earl S. Ford, MD, MPH1, Matthias B. Schulze, DRPH2, Manuela M. Bergmann, PHD2, Claus Thamer, MD3, Hans-Georg Joost, MD, PHD4 and Heiner Boeing, PHD2

1 Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
2 Department of Epidemiology, German Institute for Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany
3 Internal Medicine Department IV, University of Tübingen, Tübingen, Germany
4 Department of Pharmacology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, Germany

Corresponding author: Matthias B. Schulze, DrPH, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-115, 14558 Nuthetal, Germany. E-mail: mschulze{at}dife.de

OBJECTIVE—We sought to examine the association between plasma concentrations of liver enzymes {gamma}-glutamyltransferase (GGT) and alanine transaminase (ALT) and incident diabetes, prospectively.

RESEARCH DESIGN AND METHODS—We conducted a case-cohort analysis of data from participants mainly aged 35–65 years in the European Prospective Investigation into Cancer and Nutrition–Potsdam Study. The analytic sample included 787 participants with incident diabetes and 2,224 participants without diabetes.

RESULTS—Concentrations of GGT and ALT were significantly associated with incident diabetes after extensive adjustment. Compared with participants in the lowest quintile of GGT, the adjusted hazard ratios for increasing quintiles were 1.13 (95% CI 0.66–1.93), 1.67 (1.01–2.77), 2.77 (1.71–4.49), and 2.67 (1.63–4.37), respectively (P for linear trend <0.001). Compared with participants in the lowest quintile of ALT, the adjusted hazard ratios for incident diabetes were 0.93 (0.56–1.53) for quintile 2, 1.28 (0.83–1.96) for quintile 3, 1.35 (0.88–2.07) for quintile 4, and 1.93 (1.27–2.92) for quintile 5 (P for linear trend = 0.002). The magnitude of the associations were higher among men than women for GGT (P = 0.004) but did not differ significantly between men and women for ALT (P = 0.307).

CONCLUSIONS—Concentrations of GGT and ALT were significant predictors of incident diabetes in this study, even at concentrations still considered to be within the normal range.

Abbreviations: ALT, alanine transaminase • EPIC, European Prospective Investigation into Cancer and Nutrition • GGT, {gamma}-glutamyltransferase


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