RT Journal Article
SR Electronic
T1 The Relationship of Hepatitis Antibodies and Elevated Liver Enzymes with Impaired Fasting Glucose and Undiagnosed Diabetes
JF The Journal of the American Board of Family Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 497
OP 503
DO 10.3122/jabfm.2008.06.080047
VO 21
IS 6
A1 Mainous, Arch G.
A1 Diaz, Vanessa A.
A1 King, Dana E.
A1 Everett, Charles J.
A1 Player, Marty S.
YR 2008
UL http://www.jabfm.org/content/21/6/497.abstract
AB Objective: The aim of this study was to examine the relationship of hepatitis antibodies and liver enzymes with impaired fasting glucose and undiagnosed diabetes in adults.Methods: We analyzed the National Health and Nutrition Examination Survey, 1999 to 2004, a nationally representative sample of the noninstitutionalized US population. Among adults (aged ≥20 years of age) who were not problem drinkers, we examined hepatitis B and C antibodies and the liver enzymes aspartate aminotransferase (AST), alanine aminotransferase (ALT), and γglutamyl transaminase (GGT) with impaired fasting glucose and undiagnosed diabetes (unweighted, n = 5234; weighted, n = 172,626,805). Logistic regression models were computed controlling for major risk factors that drive diabetes screening, including age, gender, race, diagnosed hypertension, diagnosed hypercholesterolemia, and obesity.Results: In unadjusted analyses 51% of individuals with undiagnosed diabetes have elevated GGT versus 20% of individuals without diabetes or impaired fasting glucose (P = .01). Similarly, 43% of individuals with undiagnosed diabetes have elevated ALT versus 23% of individuals without diabetes or impaired fasting glucose (P = .01). AST and Hepatitis C antibodies were not associated with undiagnosed diabetes. In adjusted analyses, elevated GGT (odds ratio, 2.15; 95% CI, 1.44–3.20) and ALT (odds ratio, 1.84; 95% CI, 1.06–3.20) are associated with undiagnosed diabetes. Similarly, in adjusted analyses, elevated GGT (odds ratio, 1.23; 95% CI, 1.00–1.53) and ALT (odds ratio, 1.44; 95% CI, 1.15–1.79) are associated with impaired fasting glucose. Hepatitis antibodies, reporting a current liver problem, or AST were associated with having undiagnosed diabetes in adjusted analyses.Conclusions: Liver function is associated with undiagnosed diabetes and impaired fasting glucose and may justify further investigation as a risk stratification variable for undiagnosed diabetes or impaired fasting glucose.