Several studies have suggested that elevated alanine aminotransferase (ALT) is associated with insulin resistance (IR). The health examination profiles of 1313 Taiwanese subjects were investigated cross-sectionally to investigate whether nonspecific elevated ALT could reflect a likely underlying IR and was associated with impaired fasting glucose (IFG) or type 2 diabetes mellitus (T2DM). The prevalence and odds ratios (OR) for IFG/ T2DM and metabolic abnormalities in relation to elevated ALT were analyzed, revealing that subjects with metabolic syndrome (MS) all had IFG/T2DM. The elevated ALT significantly correlated with MS and IFG/T2DM (i.e., 19.9–29.2% vs. 7.8% for MS, and 27.0–31.5% vs. 16.1% for IFG/T2DM). However, after excluding MS and adjustment for age and sex, the elevated ALT alone was not consistently associated with IFG/T2DM (36 < ALT ≤ 80 IU/L with OR 0.97, 95% CI 0.58–1.61; 80 < ALT ≤ 120 IU/L with OR 0.55, 95% CI 0.13–2.37; none with ALT > 120 had IFG). The authors concluded that elevated ALT was associated with MS, but in subjects who did not meet MS criteria, elevated ALT by itself was not associated with IFG/T2DM. Diabetes Res Clin Pract. 2011 Oct;94(1):64-70. PMID: 21715038
