Alanine Aminotransferase, Body Mass Index, and Hemoglobin A1c May Be Useful Markers for Monitoring Changes in Intrahepatic Lipid Content in Japanese Patients With Overweight or Obesity and Type 2 Diabetes

Ayaka Takemoto, Yukiyoshi Sada, Takeshi Oyanagi, Yosuke Sasaki, Masakatsu Sone, Yasushi Tanaka


Background: Intrahepatic lipid (IHL) content is considered as an important marker of insulin resistance in overweight and obesity, so quantifying IHL content may be useful for assessing effects of interventions. IHL content can be quantitatively measured by hepatic proton magnetic resonance spectroscopy (1H-MRS), whereas other methods, such as computed tomography (CT) scan or ultrasound echography are semi-quantitative or qualitative analysis. But, 1H-MRS cannot be routinely performed in general hospitals, and thus, surrogate markers reflecting changes in IHL content are required. Previously, we performed three prospective studies focusing on IHL by antidiabetic drug in type 2 diabetic patients with overweight or obesity. Here, we present a combined post hoc analysis of these studies with the aim to identify optimal markers of changes in IHL content.

Methods: A total of 49 patients with body mass index (BMI)? 25 kg/m2 or fatty liver were enrolled in the previous three prospective studies. For the current analysis, we extracted age and sex at baseline and the following variables at baseline and 12 and 24 weeks after the start of drug treatment: IHL content; BMI; serum low-density lipoprotein-cholesterol (LDL-C) and triglyceride (TG); serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyl transpeptidase (gamma-GTP); hemoglobin A1c (HbA1c). We evaluated associations of the change in the variables with the change in IHL content.

Results: All variables showed significant change from baseline to 12 and 24 weeks, but not from 12 to 24 weeks. The change in BMI, AST, ALT, and HbA1c at 12 and 24 weeks showed stronger association with the change in IHL content at those times than the other variables. From multiple regression analysis at 12 weeks, the baseline value and change from baseline to 12 weeks in BMI, ALT, and HbA1c were correlated with the change in IHL content.

Conclusion: BMI, ALT, and HbA1c may be useful markers for monitoring the change in IHL content.

J Endocrinol Metab. 2022;12(2):73-78


Body mass index; Alanine aminotransferase; Hemoglobin A1c; Intrahepatic lipid content; Clinical marker; Type 2 diabetes

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