Metabolic Syndrome and Insulin Resistance Are Associated With Normal‐Range Aspartate Aminotransferase, Alanine Aminotransferase, and Their Ratio in Chinese Women With Polycystic Ovary Syndrome
Authors' conclusion
In Chinese PCOS patients, normal-range elevations in ALT and AST along with a lower AST/ALT ratio were associated with more severe manifestations of MS components, and ALT was more specific in predicting MS. Moreover, patients with higher ALT and lower AST/ALT ratios tend to exhibit more severe IR, and their ratio is superior to predict IR. The increased ALT and AST were associated with elevated myocardial enzymes, and ALT is the most sensitive indicator of renal impairment. It reinforces the need for PCOS-specific enzyme reference ranges.
Study context
- Population
- Chinese women with polycystic ovary syndrome (PCOS) with AST and ALT <40 U/L
- Participants
- 922 women
Primary result
As reported in the abstract
AST and metabolic syndrome (MS), OR (95% CI 1.01-1.08), p = 0.022
1.04
ALT and MS, OR (95% CI 1.01-1.07), p = 0.008
1.04
AST/ALT ratio and MS, OR (95% CI 0.64-0.99), p = 0.044
0.80
AST/ALT ratio and insulin resistance (IR), OR (95% CI 0.67-0.93), p = 0.005
0.79
Further findings
Diagnostic performance (ROC) for MS and IR
- ALT for MS: AUC (95% CI 0.61-0.7), cut-off 7.5, sensitivity 0.60, specificity 0.63
- 0.655
- AST/ALT ratio for IR: AUC (95% CI 0.58-0.66), cut-off 1.52, sensitivity 0.64, specificity 0.56
- 0.619
- ALT had the highest diagnostic performance for MS
Adjusted linear regression with metabolic, myocardial enzyme and kidney markers
- Positive association: AST with waist circumference (WC), SBP, triacylglycerol (TG), creatine kinase (CK), lactate dehydrogenase (LDH), creatinine (Cr), urea, cystatin-C (Cys-C); ALT with WC, TG, fasting insulin (FINS), HOMA-IR, CK, LDH, urea, Cys-C; AST/ALT ratio with HDL, QUICKI, CK, Cr, Cys-C
- Negative association: AST with HDL, fasting plasma glucose (FPG); ALT with HDL, QUICKI; AST/ALT ratio with TG, total cholesterol (TC), low-density lipoprotein (LDL), FINS, LDH
Original publication
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