Metabolic syndrome and transaminases: systematic review and meta-analysis

BACKGROUND: Metabolic syndrome (MetS) is a group of metabolic abnormalities characterised by hypertension, central obesity, dyslipidaemia and dysregulation of blood glucose, associated with the risk of diabetes, cardiovascular disease and overall mortality. The presence of elevated liver enzymes may precede the development of MetS, with alterations of the liver being observed that are directly related to metabolic problems. The study aims to provide the best evidence on the association between liver enzymes (ALT, AST, GGT) and MetS by determining the effect size of these biomarkers. METHODS: A systematic review and meta-analysis of studies indexed in PubMed and Scopus databases were performed. Study quality was assessed using the STROBE tool. The Grade Pro tool was used to evaluate the evidence, and the quantitative synthesis was performed using RevMan (Cochrane Collaboration). RESULTS: Seventeen articles comparing liver enzyme concentrations between 76,686 with MetS (MetS+) and 201,855 without MetS (MetS-) subjects were included. The concentration of ALT, AST and GGT in the MetS + subjects was significantly higher than in the control group 7.13 IU/L (CI95% 5.73–8.54; p < 0.00001; I(2) = 96%), 2.68 IU/L (CI95% 1.82–3.54; p < 0.00001; I(2) = 96%) and 11.20 IU/L (CI95% 7.11–15.29; p < 0.00001; I(2) = 96%), respectively. CONCLUSIONS: The evaluation of the relationship of liver enzymes in the pathophysiological process of MetS could lead to new insights into early diagnosis. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13098-023-01200-z.