ALT

This study investigated the relationship between alanine aminotransferase (ALT) levels in the first trimester and gestational diabetes mellitus (GDM) risk among 17,359 Chinese women. Results showed a positive association between ALT levels and GDM risk, with no clear threshold. Women with ALT levels in the middle range (22-40 U/L) and high range (≥40 U/L) had increased odds of GDM (OR: 1.41 and 1.62, respectively) compared to those with ALT <22 U/L. Additionally, the combination of elevated ALT levels (≥22 U/L) and maternal overweight/obesity significantly increased GDM risk (OR: 3.46), demonstrating an additive interaction. These findings suggest that elevated ALT, even within the normal range, is a predictor of GDM, and this risk is further amplified by overweight/obesity.