Liver enzymes such as g-glutamyltransferase (GGT) and alanine transferase (ALT) may reflect the accumulation of hepatic fat and therefore be markers of hepatic insulin resistance. In order to shed light on the issue, Ford et al. investigated the relationship between GGT and ALT and incident diabetes in men and women 35-65 years of age who participated in the European Investigation into Cancer and Nutrition (EPIC)-Potsdam Study. The analytic sample included 787 patients who eventually developed diabetes and 2,224 control participants. The mean follow-up was 6.5 years. After adjusting for basic confounders, participants in the top GGT quintile had a hazard ratio (HR) for future diabetes of 8.48 (95% CI, 5.52-13.04), whereas participants in the top ALT quintile had a hazard ratio for future diabetes of 5.55 (95% CI, 3.93-7.83). In the full model with adjustment for age, sex, educational status, smoking status, alcohol use, physical activity, waist circumference, body mass index, systolic blood pressure, as well as plasma levels of total cholesterol, HDL cholesterol, C-reactive protein, and glucose, the HR for future diabetes was 2.67 (95% CI, 1.63-4.37) for participants in the top GGT quintile and 1.54 (95% CI, 0.85-2.78) for participants in the top ALT quintile, suggesting that GGT might show better associations with diabetes incidence than ALT. The findings of EPIC-Potsdam suggest that considering liver enzymes could help clinicians better assess the diabetes risk of at-risk individuals.
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