Association between insulin and liver function tests, liver disease and cirrhosis in population-based cohorts with long term follow-up

Table 1 Baseline characteristics of the male as well as the female cohorts, n (%)

	Men		Women		P value
	N	Mean (SD)	N	Mean (SD)
Age (years)	857	64.8 (4.1)	1228	47.0 (6.3)	< 0.001
Alcohol (g/day)	848	12.8 (18.3)	1227	8.7 (11.5)	< 0.001
Glucose (mmol/L)	852	4.6 (1.1)	1226	4.1 (0.8)	< 0.001
Insulin (mIU/L)	857	13.3 (9.7)	1228	13.9 (7.1)	< 0.001
Coffee (cups per day)	855	3.9 (2.5)	1227	4.6 (2.8)	< 0.001
Waist circumference (cm)	857	95.3 (9.1)	1227	73.7 (8.5)	< 0.001
Body mass index	856	25.3 (3.2)	1228	24.1 (3.7)	< 0.001
Systolic BP (mmHg)	856	152 (23.3)	1228	134 (21.9)	< 0.001
Diastolic BP (mmHg)	855	84 (11.2)	1228	83 (10.8)	0.063
Triglycerides (mmol/L)	846	1.7 (0.9)	1228	1.2 (0.6)	< 0.001
Cholesterol (mmol/L)	848	6.7 (1.2)	1228	6.8 (1.2)	0.020
Smoking	857		1227		< 0.001
Never smoked		204 (23.8)		650 (53.0)
Quit smoking		366 (42.7)		90(7.3)
Still smoking1		287(33.5)		487(39.7)
Leisure time physical activity	854		1228		0.014
Sedentary		118 (13.8)		219 (17.8),
Moderate/regular1		736 (86.2)		1009 (82.2)
Alcohol (m/f) > 210/140 g per week1	848	110 (13.0)	1227	203 (16.5)	0.029
Elevated liver function test1	855	78 (9.1)	311	17 (5.5)	0.052

¹Indicated the numerical expression is n (%).

P values indicated differences between sexes, Mann-Whitney U test, t-test, or χ² test as appropriate. BP: Blood pressure.

Table 2 Univariable Cox regression analysis of risk factors for elevated liver function tests during follow-up (234 cases among total n = 1602)

	Hazard ratio	95%CI	P value
Sex (male vs female)	0.83	0.61-1.12	0.225
Insulin (mIU/L)	1.011	1.00-1.03	0.035
Glucose (mmol/L)	0.99	0.83-1.17	0.986
Ethanol (10 g/day)	1.131	1.03-1.23	0.007
Coffee (cups per day)	0.921	0.87-0.97	0.004
Smoking (never)	1		Reference
Smoking (former)	0.69	0.44-1.08	0.102
Smoking (current)	1.10	0.84-1-45	0.661
Leisure time physical activity (moderate/regular vs sedentary)	0.631	0.46-0.86	0.004
Waist circumference (cm)	1.021	1.00-1.03	0.023
Body mass index (kg/m2)	1.02	0.98-1.06	0.270
Age (years)	1.00	0.97-1.02	0.717
Systolic BP (mmHg)	1.00	1.00-1.01	0.180
Diastolic BP (mmHg)	1.01	1.00-1.02	0.166
Triglycerides (mmol/L)	0.99	0.80-1.21	0.889
Cholesterol (mmol/L)	0.93	0.83-1.04	0.213

¹Indicated statistically significant hazard ratios.

BP: Blood pressure.

Table 3 Multivariable Cox regression analysis with risk factors for elevated liver function tests at follow-up

	Main analysis HR (95%CI)	Sensitivity analysis HR (95%CI)
Insulin (mIU/L)	1.02 (1.00-1.03)a	1.02 (1.01-1.04)b
Ethanol (10 g/day)	1.15 (1.05-1.25)b	1.15 (1.04-1.26)b
Leisure time physical activity (moderate/regular vs sedentary lifestyle)	0.62 (0.45-0.84)b	0.60 (0.43-0.82)b
Coffee (cups per day)	0.92 (0.87-0.97)b	0.94 (0.89-0.99)a

^aP < 0.05.

^bP < 0.01.

Adjusted for sex and age. Main analysis: 234 events among total n = 1595. Sensitivity analysis (exclusion of prevalent cases with elevated liver function tests or liver disease): 215 events among total n = 1530. HR: Hazard ratio.