{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:37:47Z","timestamp":1787017067507,"version":"build-2736575974"},"reference-count":38,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T00:00:00Z","timestamp":1691366400000},"content-version":"unspecified","delay-in-days":6,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2023,7,24]]},"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aimed to clarify the relationship between serum alanine transaminase (ALT) levels and incidence of new-onset diabetes in a Japanese general population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Population-based retrospective cohort study using annual health check-up data for residents of Iki City, Nagasaki Prefecture, Japan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>A total of 5330 Japanese individuals (\u226530\u2009years old) without diabetes at baseline were analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Serum ALT levels were determined using an enzymatic method and were classified into gender-specific quartile groups as follows: group 1 (3\u201316\u2009U\/L in men and 3\u201313\u2009U\/L in women), group 2 (17\u201321\u2009U\/L in men and 14\u201316\u2009U\/L in women), group 3 (22\u201329\u2009U\/L in men and 17\u201322\u2009U\/L in women) and group 4 (30\u2013428\u2009U\/L in men and 23\u2013268\u2009U\/L in women). The study outcome was the incidence of diabetes (fasting glucose \u22657.0\u2009mmol\/L, non-fasting glucose \u226511.1\u2009mmol\/L, glycated haemoglobin \u22656.5%\u2009or use of glucose-lowering therapies).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After an average follow-up period of 5.0 years, 279 individuals developed diabetes. The incidence rate of diabetes increased with elevation of serum ALT levels (0.7% per 100 person-years in group 1, 0.9% in group 2, 0.9% in group 3 and 1.7% in group 4) (p&lt;0.001 for trend). This association was significant after adjustment for other risk factors including age, sex, obesity, hypertension, dyslipidaemia, smoking, current daily alcohol intake and regular exercise (p&lt;0.001 for trend). Comparable associations were observed between men and women (p=0.459 for interaction).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Serum ALT levels were associated with future development of diabetes in the general Japanese population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-074007","type":"journal-article","created":{"date-parts":[[2023,8,7]],"date-time":"2023-08-07T13:41:14Z","timestamp":1691415674000},"page":"e074007","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Association between serum ALT levels and incidence of new-onset diabetes in general population of Japanese: a longitudinal observational study (ISSA-CKD)"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-5357-6962","authenticated-orcid":false,"given":"Akiko","family":"Morinaga","sequence":"first","affiliation":[{"name":"Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuyo","family":"Iwanaga","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaori","family":"Maki","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamami","family":"Ueno","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine and Public 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