血清γ-谷氨酰转肽酶水平与老年2型糖尿病患者并发急性冠脉综合征的相关性研究  

Relationship between Serum Gamma-glutamyl Transferase Level and Acute Coronary Syndrome in Elderly Diabetics

作　　者：吴聪[1] 李华[1] 陈素芳[1] 冯明[1] 焦文君[1] 李天艺[1] 杨再刚[1] 岳欣阁[1] 商慧鲜 

机构地区：[1]郑州大学第一附属医院老年内分泌科,河南省郑州市450052

出　　处：《中国全科医学》2014年第8期863-866,共4页Chinese General Practice

摘　　要：目的 探讨血清γ-谷氨酰转肽酶（GGT）水平与老年2型糖尿病患者并发急性冠脉综合征的相关性.方法 选取2012年9月-2013年3月郑州大学第一附属医院心内科及老年内分泌科收治的老年患者291例,根据患病情况将患者分为2型糖尿病合并急性冠脉综合征组92例（DA组）,单纯2型糖尿病组103例（DM组）,单纯急性冠脉综合征组96例（ACS组）;另选同期在我院门诊体检健康者81例为对照组（NC组）.比较各组一般情况及血清学指标.结果 DA组BMI大于NC组、DM组和ACS组,血清GGT、糖化血红蛋白（HbA1c）、低密度脂蛋白胆固醇（LDL-C）水平高于NC组、DM组和ACS组,血清总胆固醇（TC）、三酰甘油（TG）水平均高于NC组,高密度脂蛋白胆固醇（HDL-C）水平低于NC组（P＜0.05）.Pearson相关分析结果显示,血清GGT水平与血清TG、LDL-C水平呈正相关（r=0.657,0.742,P＜0.05）.按照血清GGT水平将DA组和DM组患者分为≤17.4 U/L组49例,17.5～25.3 U/L组49例,25.4～42.7 U/L组49例,＞42.7 U/L组48例,以≤17.4 U/L组为对照组进行Logistic回归分析,结果显示,17.5～25.3 U/L组、25.4～42.7 U/L组、＞42.7 U/L组发生急性冠脉综合征的OR分别为1.41、2.03、2.23;校正BMI、HbA1c后,血清GGT水平预测老年2型糖尿病患者并发急性冠脉综合征的OR为1.784[95%CI（1.146,2.778）,P=0.010],进一步校正TG、LDL-C后,血清GGT水平预测老年2型糖尿病患者并发急性冠脉综合征的OR为1.690[95%CI（1.023,2.794）,P=0.041].结论 血清GGT水平升高是老年2型糖尿病患者并发急性冠脉综合征的独立危险因素,监测老年2型糖尿病患者血清GGT水平有助于预测急性冠脉综合征的发生.Objective To explore the relationship between serum γ-glutamyl transferase（GGT）level and acute coronary syndrome（ACS）in elderly diabetics.Methods From September 2012 to March 2013,a total of 92 senile diabetic patients with acute coronary syndrome（DA group）,103 T2DM patients（DM group）and 96 ACS patients（ACS group）admitted to the Department of Geriatrics and Endocrinology of the First Affiliated Hospital of Zhengzhou University were recruited into our study.81 healthy elderly were included as NC group.The biochemical parameters and anthropometric indices were determined using standard procedures.The comparisons of serum GGT and incidence of ACS among groups were carried out for observation.Results The BMI and serum GGT in DA group were higher than NC group,DM group and ACS group（P＜0.05）.The TC and TG in DA group were both higher than the NC group,while the HDL-C was lower than the NC group（P＜0.05）.Pearson correlation analysis showed that the serum GGT was positively correlated with TG and LDL-C（r=0.657,0.742,P＜0.05）.The patients in DA group and DM group were divided into GGT≤17.4 U/L（49 cases）,17.5-25.3 U/L（49 cases）,25.4-42.7 U/L（49 cases）,GGT＞42.7 U/L（48 cases）.Logistic regression analysis was conducted by using GGT≤17.4 U/L group as the control group.The results showed that the OR for ACS in 17.5-25.3 U/L,25.4-42.7 U/L and GGT＞42.7 U/L group was 1.41,2.03 and 2.23,respectively.After adjusting BMI and HbA1c,the OR of serum GGT in predicting ACS was 1.784[95%CI（1.146,2.778）,P=0.010].After further adjusting the TG and LDL-C,the OR of serum GGT in predicting ACS in elderly with T2DM was 1.690[95%CI（1.023,2.794）,P=0.041].Conclusion The increase of GGT level maybe an independent and significant risk factor of ACS among elder diabetics.It is necessary to monitor the GGT level in order to predict the occurrence of ACS.

关 键 词：Γ-谷氨酰转移酶 糖尿病 2型 急性冠脉综合征 老年人 

分 类 号：R541[医药卫生—心血管疾病] R587.1[医药卫生—内科学]