The Association Between Liver Function Tests and Some Metabolic Outcomes: Tehran Lipid and Glucose Study

Regarding the inconsistent reports on the potential relationship between cardiometabolic disorders, including metabolic syndrome (MetS), diabetes, hypertension (HTN) and chronic kidney disease (CKD), and elevated serum levels of liver enzymes, we conducted this study to test this hypothesis.

Men and women aged ≥ 19 years participated in the sixth examination of Tehran Lipid and Glucose study (TLGS) were recruited. Anthropometric and demographic measurements, as well as biochemical tests, were done for all participants. The odds ratio of cardiometabolic disorders in each tertile category of liver function tests (LFTs), including alanine transaminase (ALT), aspartate transaminase (AST), ALT/AST ratio, alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), and lactate dehydrogenase (LDH) were estimated using the multivariable logistic regression models.

The mean age (± SD) of participants was 48.2 (± 17.1) years, and 42.3% of the participants were men. After adjustment for confounding variables, elevated serum concentrations of ALT, AST, ALT/AST ratio, GGT, and ALP were positively associated with increased chance of develop MetS (OR = 3.80, 95% CI = 2.46 - 5.87 for ALT, OR = 1.52, 95% CI = 1.04-2.23 for AST, OR = 3.08, 95% CI = 2.05 - 4.63 for ALT/AST ratio, OR = 2.71, 95% CI = 1.80 - 4.09 for GGT, OR = 1.64, 95% CI = 1.12 - 2.38 for ALP). Elevated serum concentrations of ALT, ALT/AST ratio, GGT and ALP were also positively associated with risk of diabetes (OR = 4.32, 95% CI = 2.40 - 7.79 for ALT, OR = 3.28, 95% CI = 1.92 - 5.61 for ALT/AST ratio, OR = 2.52, 95% CI = 1.46 - 4.34 for GGT, OR = 1.74, 95% CI = 1.05 - 2.88 for ALP). Also, increased levels of ALT, GGT and ALP were positively associated with HTN (OR = 2.63, 95% CI = 1.66 - 4.17 for ALT, OR = 2.01, 95% CI = 1.30 - 3.13 for GGT, and OR = 1.90, 95% CI = 1.26 - 2.87 for ALP). Moreover, the elevated level of LDH was positively associated with CKD (OR = 2.43, 95% CI = 1.09 - 5.43).

Based on the results of the present study, LFT could be helpful for the early detection of cardiometabolic disorders.