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Hepatic markers and development of type 2 diabetes in middle aged men and women: a three-year follow-up study. The D.E.S.I.R. Study (Data from an Epidemiological Study on the Insulin Resistance syndrome).
André P., Balkau B., Born C., Royer B., Wilpart E., Charles M.-A., Eschwège E.
Diabetes & metabolism 31 (2005) 542-50 - http://www.hal.inserm.fr/inserm-00085347
(16357802)
Hepatic markers and development of type 2 diabetes in middle aged men and women: a three-year follow-up study. The D.E.S.I.R. Study (Data from an Epidemiological Study on the Insulin Resistance syndrome).
Philippe André1, 2, Beverley Balkau1, 2, C Born3, B Royer3, Elsie Wilpart4, Marie-Aline Charles1, 2, Eveline Eschwège1, 2
1 :  Epidémiologie cardiovasculaire et métabolique
INSERM : IFR69 – Université Paris XI - Paris Sud
Hôpital Paul Brousse 16, Avenue Paul Vaillant-Couturier 94807 VILLEJUIF CEDEX
France
2 :  Recherche en épidémiologie et biostatistique
INSERM : IFR69 – Université Paris XI - Paris Sud
16, Avenue Paul Vaillant-Couturier 94807 VILLEJUIF CEDEX
France
3 :  C - Institut inter-Régional pour la Santé
16357802
La Riche
France
4 :  Centre d'Examens de Santé
CPAM
Orléans
France
AIM: It has been shown, mainly in men, that gamma-glutamyltransferase (gammaGT) and alanine-aminotransferase (ALT) predict the development of type 2 diabetes. This study investigates the association between hepatic markers and the 3-year risk of diabetes. METHODS: Incident diabetes was studied in 2071 men and 2130 women without diabetes at baseline from the D.E.S.I.R. cohort. RESULTS: Adjusting on age, only gammaGT was predictive of diabetes in both sexes, whereas ALT and aspartate-aminotransferase (AST) were only predictive in men, and bilirubin was not predictive. After adjustment on classical confounding factors and on ALT activity, the odds ratios (OR) for incident diabetes increased across baseline gammaGT quartiles: 1, 3.1, 2.6, 5.0 in men (P<0.0003) and 1, 0.9, 3.2, 3.5 in women (P<0.01). The relations with ALT and AST were not significant after adjusting on gammaGT. Additional adjustment on markers of insulin resistance, BMI or fasting plasma glucose attenuated the risk associated with gammaGT in both sexes, and it remained significantly predictive only in the men. Pooling men and women, those with gammaGT above the median had adjusted ORs of developing diabetes of 13.7 (1.8-99.8) if WHR > =0.85 and 1.7 (0.6-4.8) if WHR<0.85 (interaction P<0.007). CONCLUSION: gammaGT was the main hepatic risk marker for type-2 diabetes in both sexes, especially in subjects with central adiposity.
Sciences du Vivant/Santé publique et épidémiologie
Sciences du Vivant/Médecine humaine et pathologie/Endocrinologie et métabolisme
Anglais
1262-3636

Articles dans des revues avec comité de lecture
Diabetes & metabolism
2005
31
542-50

Biological Markers – Blood Glucose – Blood Pressure – Cohort Studies – Diabetes Mellitus – Type 2 – Female – Follow-Up Studies – Humans – Insulin – Liver Function Tests – Male – Middle Aged – Questionnaires – Research Support – Non-U.S. Gov't – Risk