Alanine-aminotransferase (ALT) is an independent predictor for impaired glucose tolerance (IGT), a precursor to Type 2 diabetes, show results from a German worksite population.

The BASF (Baden Aniline and Soda Factory) Occupational Medicine and Health Protection Department offered a diabetes screening program to its 33,000 employees in 2006, of whom 1594 had their diabetes risk tested.

Michael Morcos and fellow researchers from the University of Heidelberg found that of all the employees tested, 374 had the metabolic syndrome according to the International Diabetes Federation criteria.

They also found that 285 had a medium-to-high risk for IGT and Type 2 diabetes according to the Finrisk scoring system, of whom 157, aged 49 years on average, underwent the oral glucose tolerance test.

Of the 157 individuals tested, 18% had either IGT (n=22) or Type 2 diabetes (n=5).

Following adjustment for various confounding factors including age and gender, fasting glucose and ALT were the only independent predictors of IGT.

More specifically, mean fasting glucose was 97 mg/dl in individuals with normoglycemia and 103 mg/dl in those with IGT. In addition, ALT levels were 28 U/l in normoglycemic participants and 36 U/l in those with IGT.

Participants in the upper quartile for ALT and fasting glucose had a significant 4.8 and 5.5-fold increased risk for Type 2 diabetes compared with the lower quartile, respectively.

“These data point to an important role of the liver in insulin resistance and the development of IGT in the relatively young and small population studied,” conclude the authors in the journal Acta Diabetologia.

They add: “Our data support the intention to study ALT as a potential predictive marker of IGT and diabetes Type 2 in more detail in a larger population in a prospective, randomized study.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2009

Free abstract

Type 2 diabetes and associated complications are not independent risk factors for incident venous thromboembolism (VTE), report researchers in the journal Arteriosclerosis, Thrombosis and Vascular Biology.

Diabetes has previously been reported to be a risk factor for VTE, but John Heit (Mayo Clinic, Rochester, Minnesota, USA) and colleagues hypothesized that this could be because “persons with diabetes are frequently hospitalized for major surgery or acute medical illness, or confined to a nursing home or chronic rehabilitation facility, all of which are major risk factors for incident VTE.”

To test this, the researchers identified all residents of Olmsted County in Minnesota who met criteria for incident VTE over a 25-year period from 1976 to 2000, of whom 1922, aged 64.8 years on average at baseline, were included in the analysis. A group of 2115 controls matched for age, gender, and length of medical history were used for comparison purposes.

Heit and team assessed whether Type 2 diabetes or associated complications such as retinopathy, nephropathy, neuropathy, or ketoacidosis were independent predictors of VTE.

They found that 231 VTE cases and 199 controls had a diagnosis of Type 2 diabetes. Results from univariate analysis showed that, overall, a diagnosis of diabetes was associated with a 32% increased relative risk for incident VTE.

But after adjusting for factors such as hospitalization (including for surgery), acute medical illness, and nursing home confinement, the association disappeared completely.

The researchers therefore conclude that “diabetes mellitus and diabetes microvascular complications are not associated with overall or idiopathic incident VTE.”

They add: “Our findings suggest that the more direct path to reducing VTE incidence is to reduce the need for surgery, hospitalization for acute medical illness, or nursing home confinement among persons with diabetes.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

Free abstract