血清丙氨酸氨基转移酶与代谢综合征的相关性研究  

Relationship between Serum Alanine Aminotransferase and Metabolic Syndrome

作　　者：霍丽丽[1] 白砚霞[2] 王红[1] 邓微[1] 兰玲[1] 纪立农[3] 

机构地区：[1]北京积水潭医院内分泌科,北京市100035 [2]北京积水潭医院血液科,北京市100035 [3]北京大学人民医院内分泌科

出　　处：《中国全科医学》2013年第22期2601-2603,2606,共4页Chinese General Practice

摘　　要：目的探讨血清丙氨酸氨基转移酶(ALT)水平与代谢综合征(MS)的关系。方法选取2004年6月—2005年12月为明确糖耐量状态于我院内分泌门诊进行口服葡萄糖耐量试验(OGTT)者837例,其中MS患者479例(MS组),非MS者358例(非MS组)。询问两组受检者的年龄、患病史和饮酒史。体格检查包括身高、体质量、腰围和血压,计算体质指数(BMI)。实验室检查包括OGTT空腹及2 h的血糖(FPG、2 hPG)和胰岛素(FINS、2hINS),血脂〔总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)〕和ALT水平,计算胰岛素抵抗指数(HOMA-IR)。结果 (1)MS组患者的年龄、女性比例、高血压患病率、血压、腰围、BMI、FPG、2 hPG、FINS、2 hINS、HOMA-IR、TC、TG、ALT均高于非MS组,HDL-C水平低于非MS组,差异有统计学意义(P<0.05);而两组LDL-C水平间差异无统计学意义(P>0.05)。(2)无论是男性还是女性,均可见不同MS组分个数者其血清ALT水平、BMI、腰围比较,差异有统计学意义(P<0.01);其中血清ALT水平、BMI、腰围均随着MS组分个数的增加而增加,差异均有统计学意义(P<0.05)。(3)在校正了年龄、腰围和BMI的影响后,男性血清ALT第4分位组(ALT≥37 U/L)患MS的危险性是第1分位组(ALT≤17 U/L)的4.21倍〔95%CI(2.11,8.39)〕;女性血清ALT第4分位组(ALT≥27 U/L)患MS的危险性是第1分位组(ALT≤13 U/L)的3.10倍〔95%CI(1.66,5.94)〕。结论血清ALT水平与MS的发生有关联,且随着MS组分的增加而逐渐升高。Objective To investigate the relationship between serum alanine aminotransferase（ALT） level and the metabolic syndrome（MS）.Methods A total of 837 subjects who underwent oral glucose tolerance test（OGTT） for diabetes screening at the outpatient of our department between June 2004 and December 2005 were selected.Among them,there were 479 MS cases and 358 non-MS cases.The age,medical history and drinking history of the subjects were surveyed.Height,weight,waist circumference,blood pressure,and body mass index（BMI） were measured in physical examination.Levels of fasting plasma glucose（FPG） and insulin（FINS）,2 h plasma glucose（2 hPG） and insulin（2 hINS）,blood lipids 〔total cholesterol（TC）,triglyceride（TG）,low density lipoprotein-cholesterol（LDL-C）,high density lipoprotein-cholesterol（HDL-C） 〕,and ALT were tested.Insulin resistance index（HOMA-IR） was calculated.Results（1） The age,female proportion,prevalence of hypertension,blood pressure,waist circumference,BMI,FPG,2 hPG,FINS,2 hINS,HOMA-IR,TC,TG,and ALT were higher in the MS group than those in the non-MS group;While HDL-C was lower in the MS group than that in the non-MS group（P 0.05）.No significant difference in LDL-C was observed between the two groups（P 0.05）.（2） The ALT level,BMI,and waist circumference increased with the number of MS components in both males and females（P 0.05）.（3） After adjusting for age,waist circumstance,and BMI,males in the fourth quartile of ALT（ALT≥37 U/ L） had 4.21 times the risk of MS as compared to those in the first quartile（ALT≤17 U/ L） 〔95% CI（2.11,8.39） 〕;Females in the fourth quartile of ALT（ALT≥27 U/L） had 3.10 times the risk of MS as compared to those in the first quartile（ALT≤13 U/ L） 〔95% CI（1.66,5.94） 〕.Conclusion Serum ALT level might be associated with the incidence of MS and increase with the number of MS components.

关 键 词：丙氨酸转氨酶 代谢综合征X 胰岛素抵抗 

分 类 号：R589[医药卫生—内分泌]