ArticleCardiovascular diabetology2012
Alanine aminotransferase/aspartate aminotransferase ratio is the best surrogate marker for insulin resistance in non-obese Japanese adults.
Article in Cardiovascular diabetology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 49 papers.
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49 citing papers in PubMed, 94 citations in OpenAlex.
- Review
- Insulin resistance in school-age children: comparison surrogate diagnostic markers.Pediatric research · 2026Article
- DeRitis ratio is associated with unfavorable prognosis in ACS patients.Frontiers in cardiovascular medicine · 2026Article
- Metabolic Syndrome and Insulin Resistance Are Associated With Normal-Range Aspartate Aminotransferase, Alanine Aminotransferase, and Their Ratio in Chinese Women With Polycystic Ovary Syndrome.Clinical endocrinology · 2025Article
- Association between triglyceride-glucose index and liver enzymes in adults with metabolic syndrome: a retrospective cross-sectional study.Annals of medicine · 2025Article
- Evaluation of a novel albumin platelet product (APP) fibrosis index and three non-invasive fibrosis indices in metabolic dysfunction-associated steatotic liver disease.Canadian liver journal · 2025Article
- Association of hepatic biomarkers with incident diabetes: a mediation analysis of the triglyceride-glucose index in a large Chinese cohort.Lipids in health and disease · 2025Article
- The association between the AST/ALT ratio and osteopenia or osteoporosis in patients with type 2 diabetes mellitus.Endocrine connections · 2025Article
- Developing CGMap: Characterizing Continuous Glucose Monitoring Data in Patients with Type 2 Diabetes.Biomedicines · 2025Article
- The De Ritis ratio mediates the association between creatinine-to-body weight ratio and normoglycemic conversion in Chinese health examinees.Scientific reports · 2025Article
- Association between AST/ALT ratio and the risk of gestational diabetes mellitus in Korean pregnant women.PloS one · 2025Article
- Association between the aspartate aminotransferase-to-alanine aminotransferase ratio and the reversion to normoglycemia in people with impaired fasting glucose: a 5-year retrospective cohort study.Frontiers in endocrinology · 2025Article
- Association between the ratio of aspartate aminotransferase to alanine aminotransferase and risk of diabetes and the mediating effect of BMI: a comparative analysis in Chinese and Japanese populations.Frontiers in endocrinology · 2025Article
- Insulin Resistance as a Risk Factor for Flavum Hypertrophy in Lumbar Spinal Stenosis.Spine surgery and related research · 2024Article
- A novel predictive model for optimizing diabetes screening in older adults.Journal of diabetes investigation · 2024Article
- Associations of maternal liver biomarkers in the first trimester with the risk of hypertensive disorders of pregnancy.Hypertension research : official journal of the Japanese Society of Hypertension · 2024Article
- Development and validation of machine learning-augmented algorithm for insulin sensitivity assessment in the community and primary care settings: a population-based study in China.Frontiers in endocrinology · 2024Article
- Article
- Elevated ALT/AST ratio as a marker for NAFLD risk and severity: insights from a cross-sectional analysis in the United States.Frontiers in endocrinology · 2024Article
- Association between serum leptin concentrations and homeostasis model assessment-insulin resistance of 2.5 and higher in normal weight Japanese women.Scientific reports · 2023Article
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Authors and funding
6 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe aim of the present study was to examine how liver markers are associated with insulin resistance in Japanese community-dwelling adults.
methodsThis cross-sectional study included 587 men aged 58 ± 14 (mean ± standard deviation; range, 20-89) years and 755 women aged 60 ± 12 (range, 21-88) years. The study sample consisted of 998 (74.4%) non-obese [body mass index (BMI) <25.0 kg/m2] and 344 (25.6%) overweight (BMI ≥ 25 kg/m2) subjects. Insulin resistance was defined by homeostasis model assessment of insulin resistance (HOMA-IR) of at least 2.5, and HOMA-IR and potential confounders were compared between the groups. Areas under the curve (AUC) of the receiver operating characteristic curves (ROC) were used to compare the power of these serum markers.
resultsIn non-obese subjects, the best marker of insulin resistance was alanine aminotransferase (ALT)/aspartate aminotransferase (AST) ratio of 0.70 (95% confidence interval (CI), 0.63-0.77). In overweight subjects, AUC values for the ALT/AST ratio and ALT were 0.66 (0.59-0.72) and 0.66 (0.59-0.72), respectively. Multiple linear regression analyses for HOMA-IR showed that ALT/AST ratios were independently and significantly associated with HOMA-IR as well as other confounding factors in both non-obese and overweight subjects. The optimal cut-off point to identifying insulin resistance for these markers yielded the following values: ALT/AST ratio of ≥ 0.82 in non-obese subjects and ≥ 1.02 in overweight subjects. In non-obese subjects, the positive likelihood ratio was greatest for ALT/AST ratio.
conclusionsIn non-obese Japanese adults, ALT/AST ratio may be the best reliable marker of insulin resistance.
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