ArticlePloS one2024
Effectiveness of the ALT/AST ratio for predicting insulin resistance in a Korean population: A large-scale, cross-sectional cohort study.
Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Predictors of suboptimal glycemic control in people with type 2 diabetes and overweight or obesity: insights from baseline analysis of a diabetes-specific meal replacement study.Frontiers in nutrition · 2025Trial
- Review
- Association of AGAHR with metabolic dysfunction-associated steatotic liver disease (MASLD).Hormones (Athens, Greece) · 2026Article
- Age-stratified association between AST/ALT ratio and all-cause mortality in asthma patients: a retrospective cohort study from the NHANES database.BMC pulmonary medicine · 2026Article
- Association between ZJU index and glycemic outcomes in individuals with impaired fasting glucose: a retrospective multicenter Chinese cohort study.Frontiers in endocrinology · 2026Article
- Cardiometabolic Biomarkers and Cardiovascular Risk Stratification in Polish Military Personnel: A Chemometric Approach.International journal of molecular sciences · 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
- Recognizing the Role of Insulin Resistance in Polycystic Ovary Syndrome: A Paradigm Shift from a Glucose-Centric Approach to an Insulin-Centric Model.Journal of clinical medicine · 2025Review
- Association between Triglyceride-Glucose index and onset of type 2 diabetes in metabolic Dysfunction-Associated steatotic liver disease population.Scientific reports · 2025Article
- Possible association between metabolic dysfunction-associated steatotic liver disease predictors and hand grip strength.Scientific reports · 2025Article
- Association between De-Ritis ratio (AST/ALT) and mortality in patients with chronic kidney disease: a retrospective cohort study.Scientific reports · 2025Article
- Metabolic outcomes in non-alcoholic and alcoholic steatotic liver disease among Korean and American adults.BMC gastroenterology · 2025Article
- Association between AST/ALT ratio and the risk of gestational diabetes mellitus in Korean pregnant women.PloS one · 2025Article
- Associations of ALT, AST and ALT/AST ratio with metabolically unhealthy obesity in the elderly.Frontiers in nutrition · 2025Article
- 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
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4 authors.
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Abstract
Insulin resistance is a common pathophysiology in patients with type 2 diabetes mellitus, cardiovascular disease, and non-alcoholic fatty liver disease. Thus, screening for the risk of insulin resistance is important to prevent disease progression. We evaluated the alanine aminotransferase/aspartate aminotransferase (ALT/AST) ratio to predict insulin resistance in the general population, regardless of comorbidities. Datasets from the 2015, 2019, and 2020 Korea National Health and Nutrition Examination Surveys were used, and the following four indices were implemented to indicate insulin resistance: fasting serum glucose, insulin, homeostatic model assessment for insulin resistance (HOMA-IR), and β-cell function. We analyzed the degree of association between the liver enzyme profile and insulin resistance indices using Pearson's correlation coefficient and determined the associations using linear or logistic regression analysis. Accordingly, ALT levels in both sexes were positively and consistently correlated with the four aforementioned insulin resistance indices in stratification analyses based on diabetes, dyslipidemia, alcohol consumption, and obesity status. In multivariate linear regression, when comparing with ALT levels, the ALT/AST ratio exhibited superior predictive performance for fasting serum glucose and HOMA-β in Korean men and improved outcomes for all insulin resistance indices in Korean women. In this analysis that included a large community-based population, the ALT/AST ratio was a more useful predictive marker than the HOMA-IR. Regarding the predicted presence or absence of insulin resistance, the ALT/AST ratio could better predict HOMA-IR than the ALT level alone in Koreans. A simple, precise marker that represents the ALT/AST ratio could be a practical method to screen for insulin resistance in the general population, regardless of diabetes mellitus, alcohol intake, and sex.
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