Association between the ratio of aspartate aminotransferase to alanine aminotransferase and risk of diabetes and the mediating effect of BMI: a comparative analysis in Chinese and Japanese populations

Our study unveils significant ethnic variations in the AST/ALT-diabetes interaction, highlighting population-specific diagnostic thresholds and mediation mechanisms. These insights advocate for customized screening approaches and suggest that AST/ALT and BMI-targeted interventions may yield differential outcomes across East Asian populations, emphasizing the critical need for precision-based medical strategies.