ALT/AST Ratio, A potential Predictor of GDM: Study

Previous studies have shown that non-alcoholic fatty liver disease (NAFLD) is associated with impaired glucose homeostasis and a higher risk of GDM. However, studies investigating ALT/AST in early pregnancy among patients with subsequent risk of GDM is limited. Therefore, Dr Tao Yuan and his team conducted a study to find the association between ALT/AST and the incidence of GDM.

They conducted a prospective, double-centre, observational cohort study that includes 1128 pregnant women. They assessed the ALT, AST and total bilirubin (TBil) during 6– 12 weeks of gestation and conducted a 75-g oral glucose tolerance test (OGTT) during 24– 28 weeks of gestation to screen GDM. They used a linear regression model to analyze the association between ALT/AST and glucose concentration during OGTT. They further used the area under the receiver operating characteristic curve (ROC-AUC) to calculate the discriminatory values of ALT/AST and triglyceride/high-density lipoprotein cholesterol (TG/HDL-C) for GDM.

Key findings of the study:

• Among 1128 pregnant women, the researchers observed that the incidence of GDM was 22.07% (n=249).
• Upon analysis, the researchers found that ALT/AST was higher in the GDM group than in the NGT group (0.92 vs 0.80).
• They also found a positive relationship between ALT/AST and glucose concentration in fasting blood glucose, 1-hour and 2-hour during OGTT(0.089, 0.176 and 0.115 respectively).
• They noted that the odds ratio of ALT/AST for incidence of GDM was 1.603.
• They also noted that the ROC-AUC of ALT/AST and TG/HDL-C reached 0.61 and 0.619.

The authors concluded, "ALT/AST in early pregnancy was an independent risk factor of GDM. The predictive ability of ALT/AST was similar to TG/HDL-C for GDM."

For further information:

DOI: https://doi.org/10.2147/IJGM.S332946