Key result
Elevated APRI scores are linked to ~155% higher hyperglycemia risk, with ALT APRI performing best.
Why the study?
The association between circulating glucose levels and the AST-platelet ratio index and ALT-platelet ratio index remains poorly studied.
Do elevated AST and ALT APRI scores predict hyperglycemia in a general population?
Cross-Sectional (n=14,177)
Do elevated AST and ALT APRI scores predict hyperglycemia in a general population?
AST and ALT APRI scores are inexpensive, novel markers that are significantly associated with fasting blood glucose levels and may aid in screening for dysglycemia.
Answers are grounded in this paper and cite their sources.
May support APRI scores for dysglycemia screening; leaves open prospective validation beyond cross-sectional associations.
Background: Hyperglycemia is a common symptom of numerous conditions, most notably diabetes mellitus and Cushing’s syndrome, and the liver plays a pivotal role in the regulation of glucose metabolism. The AST–platelet ratio index (AST APRI score) and ALT–platelet ratio index (ALT APRI score) are novel parameters whose association with circulating glucose levels remains poorly studied. Methods: Laboratory data of 14,177 subjects were retrospectively analyzed for the association between AST and ALT APRI scores and fasting blood glucose (FBG) using the Mann–Whitney U and Kruskal–Wallis tests, Spearman’s rank correlation coefficient, prevalence and odds ratio (OR) and ROC curve analysis. Results: AST and ALT APRI scores showed progressive increases with FBG, and the mean FBG was significantly higher in subjects with high AST (104.9 ± 0.33 to 120.8 ± 3.27, p < 0.0001) and ALT (104.7 ± 0.34 to 111.6 ± 1.30, p < 0.0001) APRI scores. However, the AST APRI score but not the ALT APRI score was affected by age and gender. Notably, both elevated AST and ALT APRI scores were more prevalent in hyperglycemic subjects irrespective of gender and were associated with FBG, albeit through mediator variables. Increased AST (OR = 2.55, 95% CI: 1.46–2.06, p < 0.0001) and ALT (OR = 1.73, 95% CI: 1.46–2.06, p < 0.0001) APRI scores carried a significantly higher risk for hyperglycemia. Importantly, the ALT APRI score was superior to that of the AST APRI score in distinguishing hyperglycemic subjects. Conclusions: The AST and ALT APRI scores are inexpensive, novel markers of FBG and may serve as supportive evidence in the diagnosis and management of hyperglycemic conditions.
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Alshuweishi et al. (2023) conducted a cross-sectional in Dysglycemia (n=14,177). Elevated AST and ALT APRI scores vs. Normal APRI scores was evaluated on Risk of hyperglycemia (OR 2.55, 95% CI 1.46-2.06, p=<0.0001). Elevated AST and ALT APRI scores were associated with a significantly higher risk for hyperglycemia, with the ALT APRI score showing superior diagnostic accuracy.
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