• Lizhi Tang, Bo Yuan, Fang Zhang, Hongyi Cao, Zhe Yan, Jing Li, Jobin John, and Nanwei Tong.
• Division of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, China.
• Postgrad Med J. 2018 Nov 1; 94 (1117): 641-646.

BACKGROUND : Elevation of hepatic enzymes is associated with insulin resistance, dyslipidaemia and obesity. However, the factors behind elevation of liver enzymes remain unclear. The aim of this study was to compare the role of abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) in relation with serum alanine aminotransferase (ALT) and gamma glutamyltransferase (GGT) in middle-aged Chinese adults. METHODS : We performed a cross-sectional study on 959 adults aged 40-65 without hepatitis. VAT and SAT were measured at the level of L4-L5 by MRI. Pearson correlation and linear regression were performed to assess the association of VAT/SAT with serum ALT and GGT. Logistic regression was used to evaluate the association of VAT and SAT with high ALT (≥40 U/L) and high GGT (≥35 U/L). ResultsVAT had higher correlation coefficient r with ALT and GGT than SAT. VAT, but not SAT, was associated with ALT (males: β=0.15, p=0.01; females: β=0.17, p=0.02) and GGT (males: β=0.39, p<0.0001) in linear regression. VAT remained to be associated with GGT in males (β=0.33, p=0.0001) when was further adjusted. Logistic regression showed that VAT was associated with elevated GGT (OR=2.218, p=0.043) in males but not in females and no such association was observed for SAT. ConclusionsIncreased VAT, but not SAT, was associated with elevation of hepatic enzymes including ALT and GGT. Moreover, VAT was associated with elevated GGT independent of insulin resistance and subcutaneous fat in males.© Author(s) (or their employer(s)) 2018. No commercial re-use. See rights and permissions. Published by BMJ.

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