Nonlinear relationship between aspartate aminotransferase to alanine aminotransferase ratio and the risk of prediabetes: A retrospective study based on chinese adults

• Published in: Frontiers in endocrinology (Lausanne) 2022-10, Vol.13, p.1041616-1041616
• Main Authors: Cao, Changchun, Zhang, Xiaohua, Yuan, Junhu, Zan, Yibing, Zhang, Xin, Xue, Chao, Wang, Yulong, Zheng, Xiaodan
• Format: Article
• Language: English
• Subjects: AST/ALT ratio; Endocrinology; insulin resistance; metabolic syndrome; nonlinearity; prediabetes
• ISSN: 1664-2392; 1664-2392
• DOI: 10.3389/fendo.2022.1041616

ObjectiveRecent evidence has revealed that the aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT ratio) may be closely associated with metabolic syndrome and insulin resistance. However, it is unclear whether the AST/ALT ratio correlates with prediabetes risk. The aim of our study was to examine the association between AST/ALT ratios and the risk of prediabetes among a large cohort of Chinese subjects. MethodsThis retrospective cohort study recruited 75204 Chinese adults with normoglycemia at baseline who underwent physical examinations at the Rich Healthcare Group from 2010 to 2016. The AST/ALT ratio at baseline was the target independent variable, and the risk of developing prediabetes during follow-up was the dependent variable. Cox proportional-hazards regression was used to evaluate the independent association between the AST/ALT ratio and prediabetes. This study identified nonlinear relationships by applying a generalized additive model (GAM) and smooth curve fitting. In order to assess the robustness of this study, we performed a series of sensitivity analyses. Moreover, we performed a subgroup analysis to evaluate the consistency of the association in different subgroups. Data from this study have been updated on the DATADRYAD website. ResultsThe AST/ALT ratio was negatively and independently related to the prediabetes risk among Chinese adults (HR: 0.76, 95% CI: 0.75-0.84, P