ArticleScientific reports2016
Plasma Levels of Alanine Aminotransferase in the First Trimester Identify High Risk Chinese Women for Gestational Diabetes.
Article in Scientific reports, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.
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24 citing papers in PubMed, 3 syntheses or guidelines pooled it, 41 citations in OpenAlex.
- Liver Enzyme Biomarkers Before or in Early Pregnancy as Predictors for Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis.Journal of the ASEAN Federation of Endocrine Societies · 2026Pooled it
- Asian Pacific association for the study of liver (APASL) guidelines: hepatitis B virus in pregnancy.Hepatology international · 2022Guideline
- The association of plasma levels of liver enzymes and risk of gestational diabetes mellitus: a systematic review and dose-response meta-analysis of observational studies.Acta diabetologica · 2020Pooled it
- First trimester hepatic steatosis index as a predictor of gestational diabetes mellitus: a cohort study in Northwestern China.Scientific reports · 2025Article
- The effect of early pregnancy ALT elevation on neonatal birth weight: The mediating role of gestational diabetes mellitus.PloS one · 2025Article
- Association between AST/ALT ratio and the risk of gestational diabetes mellitus in Korean pregnant women.PloS one · 2025Article
- Nonlinear association between alanine aminotransferase to high-density lipoprotein cholesterol ratio and risk of gestational diabetes mellitus.Scientific reports · 2024Article
- The associations of maternal liver biomarkers in early pregnancy with the risk of gestational diabetes mellitus: a prospective cohort study and Mendelian randomization analysis.Frontiers in endocrinology · 2024Article
- Diagnostic Approach to Elevated Liver Function Tests during Pregnancy: A Pragmatic Narrative Review.Journal of personalized medicine · 2023Article
- Liver biomarkers, lipid metabolites, and risk of gestational diabetes mellitus in a prospective study among Chinese pregnant women.BMC medicine · 2023Article
- Alanine aminotransferase to high- density lipoprotein cholesterol ratio is positively correlated with the occurrence of diabetes in the Chinese population: a population-based cohort study.Frontiers in endocrinology · 2023Article
- AST-to-ALT ratio in the first trimester and the risk of gestational diabetes mellitus.Frontiers in endocrinology · 2022Article
- Association of leukocyte counts in the first trimester with glucose intolerance during pregnancy.Journal of diabetes investigation · 2022Article
- Association between pregravid liver enzyme levels and gestational diabetes in twin pregnancies: a secondary analysis of national cohort study.Scientific reports · 2021Article
- The Predictive Ability of Hepatic Steatosis Index for Gestational Diabetes Mellitus and Large for Gestational Age Infant Compared with Other Noninvasive Indices Among Chinese Pregnancies: A Preliminary Double-center Cohort Study.Diabetes, metabolic syndrome and obesity : targets and therapy · 2021Article
- Risk Factors Screening for Gestational Diabetes Mellitus Heterogeneity in Chinese Pregnant Women: A Case-Control Study.Diabetes, metabolic syndrome and obesity : targets and therapy · 2021Article
- Development and validation of an early pregnancy risk score for the prediction of gestational diabetes mellitus in Chinese pregnant women.BMJ open diabetes research & care · 2020Article
- Trimethylamine N-Oxide Metabolites in Early Pregnancy and Risk of Gestational Diabetes: A Nested Case-Control Study.The Journal of clinical endocrinology and metabolism · 2019Article
- Bile acid metabolites in early pregnancy and risk of gestational diabetes in Chinese women: A nested case-control study.EBioMedicine · 2018Article
- Liver Enzymes in Early to Mid-pregnancy, Insulin Resistance, and Gestational Diabetes Risk: A Longitudinal Analysis.Frontiers in endocrinology · 2018Article
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Authors and funding
12 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Alanine aminotransferase (ALT) predicts type 2 diabetes but it is uncertain whether it also predicts gestational diabetes mellitus (GDM). We recruited 17359 Chinese women with ALT measured in their first trimester. At 24-28 weeks of gestation, all women underwent a 50-gram 1-hour glucose challenge test (GCT) followed by a 75-gram 2-hour oral glucose tolerance test if GCT result was ≥7.8 mmol/L. Restricted cubic spline analysis was used to examine full-range risk associations of ALT levels with GDM. Relative excess risk due to interaction, attributable proportion due to interaction and synergy index were used to estimate additive interaction between high ALT and overweight/obesity for GDM. Finally, 1332 (7.7%) women had GDM. ALT levels were positively associated with GDM risk without a clear threshold. Using ALT levels <22 U/L as the referent, the middle ALT levels (≥22 to <40 U/L) [odds ratio (OR) (95% confidence intervals): 1.41(1.21-1.65)] and high ALT levels (≥40 U/L) [1.62 (1.31-2.00)] were associated with increased GDM risk. Maternal overweight/obesity greatly enhanced the OR of ALT ≥22 U/L from 1.44 (1.23-1.69) to 3.46 (2.79-4.29) with significant additive interactions. In conclusion, elevated ALT levels in the first trimester even within normal range predicted GDM risk, further enhanced by overweight/obesity.
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