{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T17:37:33Z","timestamp":1788543453881,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T00:00:00Z","timestamp":1781827200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background &amp; Aims<\/jats:title>\n                    <jats:p>Aminotransferases are widely used for metabolic dysfunction\u2010associated steatotic liver disease (MASLD) evaluation, especially in type 2 diabetes mellitus (T2DM). Whether within\u2010person seasonal variation affects classification near commonly used thresholds or relates to long\u2010term metabolic outcomes remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This registry\u2010based cohort analysed monthly aspartate aminotransferase (AST) and alanine aminotransferase (ALT) measurements from 6039 adults with T2DM in the Japan Diabetes Clinical Data Management registry (2014\u20132020). Classification discordance across the 30\u2009IU\/L threshold was compared between winter\u2010mean and summer\u2010mean values. Individual seasonal amplitude was derived from seasonal\u2010trend decomposition of multiply imputed monthly time series. Final glycated haemoglobin (HbA1c) and non\u2010achievement of HbA1c &lt;\u20097% were analysed using multivariable regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Both AST and ALT showed significant seasonal variation, with the highest values in late autumn to early winter and the lowest in summer (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Approximately one in nine patients with borderline ALT values showed discordant winter\u2010summer classification. Each 1\u2010SD increase in AST amplitude was associated with 0.06 percentage points higher final HbA1c (95% CI, 0.04\u20130.08) and higher odds of not achieving HbA1c &lt;\u20097% (odds ratio, 1.14; 95% CI, 1.08\u20131.21;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). ALT amplitude showed a similar but weaker, less consistent association.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>AST and ALT exhibited reproducible seasonal variation peaking in late autumn to early winter, with approximately one in nine patients near the MASLD screening threshold reclassified depending on season. Greater seasonal amplitude, especially AST, was independently associated with poorer glycemic control, supporting season\u2010aware interpretation in routine clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.70743","type":"journal-article","created":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T03:50:22Z","timestamp":1781927422000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Within\u2010Person Seasonal Variability of Aminotransferases and Long\u2010Term Glycemic Control in Adults With Type 2 Diabetes (\n                    <scp>JDDM<\/scp>\n                    85)"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3348-4645","authenticated-orcid":false,"given":"Ryota","family":"Toki","sequence":"first","affiliation":[{"name":"Department of Preventive Medicine and Public Health Keio University School of Medicine  Shinjuku\u2010ku Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaya","family":"Sakamoto","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Metabolism &amp; Endocrinology, School of Medicine International University of Health and Welfare  Chiba Japan"},{"name":"Department of Diabetes, Metabolism &amp; Endocrinology International University of Health and Welfare Mita Hospital  Tokyo Japan"},{"name":"Department of Internal Medicine Tsuruoka Kyoritsu Hospital  Tsuruoka\u2010shi Yamagata Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Yuki","sequence":"additional","affiliation":[{"name":"Department of Diabetes, Metabolism &amp; Endocrinology, School of Medicine International University of Health and Welfare  Chiba Japan"},{"name":"Department of Clinical Medical Sciences, Graduate School of Medicine International University of Health and Welfare  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miho","family":"Iida","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Public Health Keio University School of Medicine  Shinjuku\u2010ku Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michiko","family":"Yamazaki","sequence":"additional","affiliation":[{"name":"Department of Social Medical Sciences, Graduate School of Medicine International University of Health and Welfare  Tokyo Japan"},{"name":"Patient Engagement Frontier Medical Science KAKEHASHI Inc.  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