ArticleScientific reports2025
Elevated liver enzyme trajectories in early adulthood and persistently high levels predict type 2 diabetes risk in Japanese adults.
Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
This study examined long-term trajectories of liver enzyme levels and their associations with type 2 diabetes risk in Japanese adults. Data were analyzed from 24,380 individuals aged 30-64 years at baseline without type 2 diabetes, comprising 296,171 health check-up records from the Hitachi Cohort Study. Liver enzyme levels, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT), were measured annually. Over a mean follow-up of 12.8 years, 3,840 participants (15.8%) developed type 2 diabetes. Group-based trajectory modeling identified six ALT, three AST, and four GGT trajectory groups. Persistently elevated ALT levels and trajectories with early-adulthood elevation were strongly linked to increased type 2 diabetes risk. The persistently elevated ALT group (Group 6) exhibited an odds ratio (OR) of 7.97 (95% CI: 7.40-8.57), while the early-adulthood elevated group (Group 5) showed an OR of 4.23 (95% CI: 4.00-4.48) compared to the consistently low group (Group 1). Repeated exceedance of ALT and AST thresholds significantly increased type 2 diabetes risk, with higher thresholds and frequencies of exceedance showing stronger associations. Regular liver enzyme monitoring may help identify high-risk individuals, supporting early intervention strategies to mitigate type 2 diabetes incidence.
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