ALT/AST Ratio, A potential Predictor of GDM: Study
The prevalence of gestational diabetes mellitus (GDM) has increased sharply worldwide. As one of the most common medical complications of pregnancy, GDM increases the risk of pregnancy complications and adverse perinatal outcomes.
In a recent study, researchers have reported the alanine transaminase-to-aspartate aminotransferase ratio (ALT/AST) as an independent risk factor for GDM. The study findings were published in the International Journal of General Medicine on 05 January 2022.
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:
