Changes in Alanine Aminotransferase/ Aspartate Aminotransferase Ratio Are Associated with Changes in Insulin Resistance in Japanese Community-Dwelling Middle-Aged and Elderly Women

Liver marker {e.g.,alanine aminotransferase (ALT) and aspartate aminotransferase (AST)} levelsindependently predict insulin resistance. The aim of the present study is toexamine how changes in liver markers are associated with changes in insulin resistance after exercise inJapanese community-dwelling adults. Theparticipants were 76 women aged 67 ± 6 years from a rural village. Nordic walk(NW) exercise of 120 min per week was performed for 12 weeks. Before and at theend of the 12-week intervention, various confounding factors and insulinresistance {e.g., HomeostaticModel Assessment of Insulin Resistance (HOMA-IR)}were measured. The baseline, follow-up, and changes in ALT/AST ratio (β = 0.390, P β =0.393, P β = 0.321, P = 0.004, respectively)were each significantly and independently associated with HOMA-IR. When thedata were further stratified by baseline and change in ASL/AST ratio, changesin HOMA-IR decreased more significantly in participants with baseline ASL/ASTratio ≥ 0.762 and change in ALT/AST ratio of P = 0.002 and ASL/AST ratio ≥0.762, P = 0.047). This study is of interest becauseliver transaminase markers, which are inexpensive and routinely collected inclinical settings, may provide a simple and accurate enhancement to modelscurrently used to identify subjects with changes in insulin resistance. These results suggest that a higherbaseline and decreased change in ALT/AST ratio may be a predictor for decreasedinsulin resistance after a 12-week walking exercise in community-dwellingmiddle-aged and elderly women.