Prevalence of metabolic syndrome (Mets) is increasing in Iran. It becomes a major public health. In most cases, subjects with Mets are not recognized on time, therefore, using simple and sensitive indicators for determining Mets are necessary. Previously, it has been reported that there is relationship between liver enzymes and Mets, but the results are inconsistent and the conclusions are underpowered. Therefore, the aims of this study are to determine which liver enzymes are good predictors of metabolic syndrome in Azar Cohort population.

In the present study, the data of 14997 subjects who participated in Azar cohort study were cross-sectionally analyzed. Metabolic syndrome was defined according to International Diabetes Federation (IDF) criteria. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphates (ALP) and gamma-glutamyltransferase (GGT) were determined by kits. The associations of serum liver markers with Mets were analyzed using logistic regression models.

In our study, the prevalence of Mets is 34%. The greater serum GGT, ALP and ALT quartiles are positively associated with Mets (P<0.001). Among liver enzymes, all GGT quartiles (Q) especially 4 th quartile (≥29 IU/l) is more predictive of Mets. The increased risk of Mets by high GGT levels (4 th quartile) became more obvious after adjustment for age and gender 3.82 (95%confidence interval, l 3.37-4.33). AST and AST/ALT are negatively correlated with Mets.

on the basis of our findings, liver enzymes especially GGT could be used as clinical predictors of MetS, because the test is inexpensive, highly sensitive, and frequently encountered in clinical practice. Moreover, individuals with high normal GGT levels require close monitoring for high risk of MetS.