RT Journal Article SR Electronic T1 The effect of liver enzymes on body composition: a Mendelian randomization study JF bioRxiv FD Cold Spring Harbor Laboratory SP 732685 DO 10.1101/732685 A1 Jun Xi Liu A1 Shiu Lun Au Yeung A1 Man Ki Kwok A1 June Yue Yan Leung A1 Lai Ling Hui A1 Gabriel Matthew Leung A1 C. Mary Schooling YR 2019 UL http://biorxiv.org/content/early/2019/08/14/732685.abstract AB Background Higher alanine transaminase (ALT) is positively associated with diabetes but inversely associated with body mass index (BMI) in Mendelian randomization (MR) studies, suggesting liver function may affect body composition. To clarify, we assessed the association of liver function with muscle and fat mass observationally with two-sample MR as a validation.Methods In the population-representative “Children of 1997” birth cohort, we used multivariable linear regression to assess the adjusted associations of ALT and alkaline phosphatase (ALP) (IU/L) at ~17.5 years with muscle mass (kg) and body fat percentage (%). Genetic variants predicting ALT, ALP and gamma glutamyltransferase (GGT) (100% change in concentration) were applied to fat-free and fat mass (kg) in the UK Biobank (n=~331,000) to obtain unconfounded estimates using MR.Results Observationally, ALT was positively associated with muscle mass (0.11, 95% confidence interval (CI) 0.10 to 0.12) and fat percentage (0.15, 95% CI 0.13 to 0.17). ALP was inversely associated with muscle mass (−0.03, 95% CI −0.04 to −0.02) and fat percentage (−0.02, 95% CI −0.03 to −0.01). Using MR, ALT was inversely associated with fat-free mass (−0.41, 95% CI −0.64 to −0.19) and fat mass (−0.58, 95% CI −0.85 to −0.30). ALP was not clearly associated with body composition. GGT was positively associated with fat-free (0.30, 95% CI 0.01 to 0.06) and fat mass (0.41, 95% CI 0.10 to 0.71).Conclusion ALT reducing fat-free mass provides a possible pathway for the positive association of ALT with diabetes, and suggests a potential target of intervention.