Relationship Between Ast/Alt Ratio And Peripheral Nerve Function In Type 2 Diabetes Mellitus

Background: The aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio is suggested to be related to the increased risks of many metabolic diseases, whereas its association with neurological function in type 2 diabetes mellitus (T2DM) has not been understood. In this study, we aim to investigate the relationships between serum liver enzymes (ALT, AST, the AST/ALT ratio, gamma-glutamyl transferase (GGT)) and peripheral nerve function in patients with T2DM. Methods: In Group 1, we analyzed the associations between parameters of nerve function and liver enzymes in 460 T2DM patients from rural area of Shanghai. Besides, the same methods were applied to another group of 828 T2DM subjects from urban area of Shanghai. Results: In Group 1, the AST/ALT ratio was significantly higher in patients with abnormal nerve conduction (P = 0.005). The peripheral nerve function significantly declined with increasing tertiles of AST/ALT ratio (Ps < 0.05). After adjustment for all potential confounders, the ratio of AST/ALT was still negatively correlated with the composite Z-scores of conduction velocity (CV). In Group 2, similar significant associations were found between the AST/ALT ratio and peripheral nerve function after adjustment for covariates. Conclusions: In two independent T2DM populations, the AST/ALT ratio was independently and consistently related to peripheral nerve function. The AST/ALT ratio might be helpful to highlight T2DM patients at high risk for diabetic peripheral neuropathy.