Prediabetes is a key risk for type 2 diabetes and its remission to normal glucose regulation has been shown to prevent or delay the onset of diabetes. However, which factors play roles in remission is not fully understood. We prospectively examined the relationships between liver enzymes at baseline and future remission from impaired fasting glucose (IFG) to normal fasting glucose (NFG). We included 3334 middle-aged Japanese men with IFG and not taking diabetic medications at baseline. They were followed for up to 11 years. IFG was defined as fasting plasma glucose level 100-125 mg/dL and HbA1c <6.5%. Remission to NFG was defined as fasting plasma glucose level <100 mg/dL detected two times consecutively at the annual checkup. Those who had developed diabetes before they achieved remission to NFG were not counted as remission. Cox proportional hazard models were used to estimate hazard ratios (HRs) for achieving remission to NFG. Alanine transaminase (ALT) and aspartate transaminase (AST) were divided into the following quartiles: 5-19, 20-26, 27-37, and ≥38 IU/L for ALT; 11-19, 20-23, 24-29, and ≥30 IU/L for AST. A total of 1224 subjects remitted to NFG during 19780 person-years. Incidence rates per 1000 person-years for quartiles 1, 2, 3, and 4 of ALT/AST were 81/65, 62/67, 56/60, and 49/56, respectively. In a multiple-adjusted model that included age, fasting plasma glucose, body mass index, smoking status, regular physical exercise, alcohol consumption, and family history of diabetes, HRs of future remission to NFG for quartiles 2, 3, and 4 of ALT were 0.84 (95% CI, 0.72-0.99), 0.84 (0.72-0.99), and 0.82 (0.69-0.97), respectively, compared to quartile 1. In the same model except AST was substituted for ALT, HRs of those for quartiles 2, 3, and 4 of AST were 1.04 (0.89-1.22), 1.02 (0.87-1.20), and 1.02 (0.87-1.21), respectively, compared to quartile 1.

In conclusion, elevated ALT was inversely associated with future remission from IFG to NFG, but AST was not.


I. Shibata: None. K.K. Sato: None. M. Shibata: None. H. Koh: None. S. Uehara: None. K. Oue: None. H. Kambe: None. M. Morimoto: None. T. Hayashi: None.

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