Serum alanine transaminase is predictive of fasting and postprandial insulin and glucagon concentrations in type 2 diabetes

• Published in: Peptides (New York, N.Y. : 1980) Vol. 169; p. 171092
• Main Authors: Huang, Weikun, Xie, Cong, Wewer Albrechtsen, Nicolai J., Sang, Miaomiao, Sun, Zilin, Jones, Karen L., Horowitz, Michael, Rayner, Christopher K., Wu, Tongzhi
• Format: Journal Article
• Language: English
• Published: Elsevier Inc 01.11.2023
• Subjects: Alanine transaminase; aspartate transaminase; blood glucose; blood serum; c-peptide; fasting; gamma-glutamyltransferase; Glucagon; glucose; homeostasis; Insulin; liver; noninsulin-dependent diabetes mellitus; risk; secretion; Type 2 diabetes; Type 2 diabetes; Alanine transaminase; Glucagon; Insulin
• ISSN: 0196-9781; 1873-5169; 1873-5169
• DOI: 10.1016/j.peptides.2023.171092

The liver plays a key role in glucose homeostasis. Serum liver enzyme levels, including alanine transaminase (ALT), aspartate transaminase (AST) and gamma-glutamyl transferase (GGT), are reportedly predictive of the risk of type 2 diabetes (T2D). However, the link between the liver enzyme profile and metabolic derangements in T2D, particularly the secretion of both insulin and glucagon, is not clear. This study evaluated its relationships with glycemia, insulin and glucagon both during fasting and after an oral glucose load or a mixed meal in T2D. 15 healthy and 43 T2D subjects ingested a 75 g glucose drink. 86 T2D subjects consumed a mixed meal. Venous blood was sampled for measurements of blood glucose and plasma insulin, C-peptide and glucagon. Blood glucose, plasma insulin, C-peptide and glucagon concentrations, both fasting and after oral glucose, correlated directly with ALT, while fewer and weaker correlations were observed with GGT or AST. Subgroup analysis in T2D subjects ascertained that plasma insulin, C-peptide and glucagon concentrations after oral glucose were higher with increasing ALT. Similar findings were observed in the T2D subjects who received a mixed meal. In conclusion, serum liver enzyme profile, particularly ALT, reflects dysregulated fasting and nutrient-stimulated plasma insulin and glucagon concentrations in T2D. •Serum liver enzymes are reportedly predictive of the risk of type 2 diabetes (T2D).•The relationships of insulin and glucagon with liver enzymes are not clear in T2D.•Insulin and glucagon are augmented in T2D patients with higher liver enzymes.•ALT is most strongly related to circulating insulin and glucagon concentrations.•ALT may represent an early marker for insulin and glucagon resistance in T2D.