正常范围内谷丙转氨酶对代谢正常肥胖个体发生代谢异常性疾病的预测价值  

The Value of Normal Alanine Aminotransferase on Predicting the Occurrence of Metabolic Abnormal Diseases of Metabolically Healthy Obese Individuals

作　　者：熊璞[1,2] 张弛[1,2] 赵乃蕊[1,2] 李华珠[1,2] 杨晓春[1,2] 周桂莲[1,2] 王敏[1,2] 王霞[1,2] 陈晶[1,2] 刘瑛[1,2] 

机构地区：[1]湖南省人民医院 [2]湖南师范大学第一附属医院内分泌科,中国长沙410005

出　　处：《湖南师范大学自然科学学报》2012年第6期80-84,共5页Journal of Natural Science of Hunan Normal University

基　　金：湖南省科技计划资助项目(2011SK3160);湖南省卫生厅重点基金资助项目(A2007005);湖南省保健委重点资助项目(A2009-02)

摘　　要：目的了解代谢正常肥胖(metabolically healthy obese,MHO)个体谷丙转氨酶(alanine aminotrans-ferase,ALT)的特点;探讨正常范围内ALT活性对MHO发生代谢异常性疾病的预测价值.方法收集湖南省人民医院院体检中心2006年4月～2010年1月体检人群共4 067例,排除资料不全者,共2 830例纳入研究.其中肥胖者共1 120例,分为MHO组及肥胖伴代谢异常组.将91例血清ALT活性正常的MHO进行四分位数分组(Q1～Q4),随访1～3年后,比较不同ALT组别发生代谢异常的风险.结果 (1)MHO个体ALT活性高于正常对照者(30.71±19.59 vs 21.39±14.98,P<0.05),低于肥胖伴代谢异常者(30.71±19.59 vs 38.29±20.57,P<0.05).(2)Q3组代谢异常性疾病的发病率明显增高(69.57%vs 26.09%,OR=6.476;95%CI:1.789～23.444,P<0.05);Q4组代谢异常性疾病的发病率明显增高(63.64%vs 26.09%,OR=4.958;95%CI:1.388～17.711,P<0.05).结论 (1)MHO血清ALT活性介于正常对照与肥胖伴代谢异常者之间;(2)正常范围内血清ALT活性的升高可预测MHO代谢异常性疾病的发生.Objective： To investigate the characteristics of alanine aminotransferase（ALT） of metabolically healthy obese（MHO） individuals,and to explore the value of normal ALT on predicting the occurrence of metabolic abnormal diseases in MHO individuals.Methods： 4 067 subjects were evaluated for routine health examination in the People＇s Hospital of Hunan Province from April 2006 to January 2010,2 830 individuals were enrolled excluding those with missing data.1 120 individuals were obese.Obesity were divided into MHO and obesity with metabolic abnormality.MHO individuals with normal ALT（n=91） were divided into four groups according to the quartile of ALT（Q1~Q4）,following up for 1 to 3 years to compare the risk of incident metabolic abnormal diseases in different groups of quartile of ALT.Results：（1） The level of ALT in MHO was higher than in normal controls（30.71±19.59 vs 21.39±14.98,P0.05）,and lower than in obesity with metabolic abnormal diseases（30.71±19.59 vs 38.29±20.57,P0.05）.（2） The incidence of metabolic abnormal diseases in the third quartiles of ALT（Q3） were significantly increased than that in the lowest quartiles of ALT（Q1）（69.57% vs 26.09%,OR=6.476;95% CI： 1.789~23.444,P0.05）,the upper quartiles of ALT（Q4） were significantly increased than that in Q1（63.64% vs 26.09%,OR=4.958;95% CI： 1.388~17.711,P0.05）.Conclusions：（1） The level of ALT in MHO shows an intermediate features between obesity with metabolic abnormal diseases and normal controls.（2） Even in the normal range,the elevated ALT could predicte the risk of incident metabolic abnormal diseases in MHO.

关 键 词：肥胖 代谢正常肥胖(MHO) 谷丙转氨酶(ALT) 代谢综合征(MS) 

分 类 号：R589.2[医药卫生—内分泌]