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American Journal of Epidemiology Vol. 146, No. 7: 565-571
Copyright © 1997 by The Johns Hopkins University School of Hygiene and Public Health

research-article

Association between Diabetes and Elevated Serum Alanine Aminotransferase Activity among Mexican Americans

Arthur A. Meltzer1 and James E. Everhart2,

1Social & Scientific Systems, Inc. Bethesda, MD
2Epidemiology and Clinical Trials Branch, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases Bethesda, MD

Reprint requests to Dr. James E. Everhart, National Institute of Diabetes and Digestive and Kidney Diseases, Natcher Building Room 6AN-12J, 45 Center Drive, MSC 6600, Bethesda, MD 20892-6600.

Elevated activities of serum aminotransferases are a common sign of liver disease and are observed more frequently among diabetics than in the general population. Whether this association is due to confounding factors is unknown. The authors investigated whether diabetes was significantly associated with elevated serum activity of alanine aminotransferase (ALT) after adjustment for factors common to both diabetes and raised ALT. Data from 2,999 men and women aged 20–74 years representative of the Mexican American population of the southwestern United States were obtained from the Hispanic Health and Nutrition Examination Survey (1982–1984). Approximately 6% of men and 2% of women had elevated serum ALT activity (>43 IU/liter). The odds ratio for diabetes as a predictor of elevated ALT was 4.1 (95% confidence interval 2.3–7.6) adjusted for age and sex, which decreased to 3.0 (95% confidence interval 0.92–9.74) after adjustment for age, sex, body mass index, alcohol consumption, and other factors. In addition to diabetes, body mass index was also significantly (p < 0.05) associated with elevated ALT activity. Heavier alcohol consumption and male sex increased the likelihood of elevated ALT, whereas coffee consumption reduced it. Diabetes and liver injury appear to be associated, even with control for factors in common.

alanine aminotransferase; alcohol drinking; body mass index; confounding factors (epidemiology); diabetes mellitus; health surveys; risk factors


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