{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T16:16:39Z","timestamp":1783440999244,"version":"3.54.6"},"reference-count":26,"publisher":"Bioscientifica","issue":"5","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"vor","delay-in-days":291,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82374554"],"award-info":[{"award-number":["82374554"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Fundings for Clinical Trials from the Affiliated Drum Tower Hospital, Medical School of Nanjing University","award":["2024-LCYJ-ZXY- 02"],"award-info":[{"award-number":["2024-LCYJ-ZXY- 02"]}]}],"content-domain":{"domain":["journals.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,5,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The aim of this study was to investigate the relationship between the AST\/ALT ratio and osteopenia or osteoporosis in patients with type 2 diabetes mellitus (T2DM).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A total of 589 patients with T2DM were divided into two groups based on T-score: T-score \u2265 \u22121.0 group, normal bone mineral density and T-score &amp;lt; \u22121.0 group, osteopenia or osteoporosis (OP). The association between the AST\/ALT ratio and osteopenia\/OP was evaluated by multivariate analyses. The receiver operating characteristic (ROC) curves were used to estimate the diagnostic performance according to the area under the ROC curve (AUC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The patients in the T-score &amp;lt; \u22121.0 group showed significantly higher AST\/ALT level than those in the T-score \u2265 \u22121.0 group (0.93 \u00b1 0.16 vs 1.17 \u00b1 0.24, P &amp;lt; 0.001). According to the interquartile range of the AST\/ALT ratio, the participants were divided into four groups: Q1 (0.650, 0.874), Q2 (0.875, 0.999), Q3 (1.000, 1.173) and Q4 (1.174, 1.917). After adjustment for confounding factors, compared with Q1 of the AST\/ALT level, subjects in Q3 and Q4 remained more likely to have osteopenia or osteoporosis (Q3, OR 3.478, 95% CI 1.641\u20137.411; Q4, OR 15.278, 95% CI 6.377\u201336.837). The AST\/ALT ratio provided an AUC value of 0.81 (95% CI 0.77\u20130.84) for osteopenia or osteoporosis in patients with T2DM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>An elevated AST\/ALT ratio is associated with the evaluated risk of osteopenia\/OP in patients with T2DM. The AST\/ALT ratio, a practical and cost-effective biomarker, may be a potential predictor of osteopenia\/OP in patients with T2DM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1530\/ec-25-0086","type":"journal-article","created":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T09:36:34Z","timestamp":1745573794000},"update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-10","source":"Crossref","is-referenced-by-count":3,"title":["The association between the AST\/ALT ratio and osteopenia or osteoporosis in patients with type 2 diabetes mellitus"],"prefix":"10.1530","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2701-8566","authenticated-orcid":true,"given":"Yuan","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Endocrine and Metabolic Disease Medical Center, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine 1 , ,","place":["Nanjing, China"]},{"name":"Branch of National Clinical 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