血清谷丙转氨酶对代谢正常肥胖个体发生非酒精性脂肪性肝病的预测价值  

The Value of Alanine Aminotransferase on Predicting the Occurrence of Nonalcoholic Fatty Liver Disease in Metabolically Healthy Obese Individuals

作　　者：谢环[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] 熊璞[1,2] 陈晶[1,2] 王霞[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》2014年第3期28-31,共4页Journal of Natural Science of Hunan Normal University

基　　金：湖南省科技计划基金资助项目(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：选取2006年4月~2010年1月期间在湖南省人民医院体检的人员中资料齐全、于1~3年后随访的1 367例,比较正常对照组、代谢正常肥胖（Metabolically Healthy Obese,MHO）及肥胖伴代谢综合征（MS）三组的血清谷丙转氨酶（alanine aminotransferase,ALT）活性.将血清ALT活性正常的MHO（n=40）行四分位数分组（A、B、C、D组）,比较4组MHO个体发生非酒精性脂肪性肝病（NAFLD）的发病情况,分析不同组别发生NAFLD的风险.结果：（1）MHO个体ALT水平低于肥胖伴MS者（30.71±19.59 vs 39.47±27.56,P〈0.05）,高于正常对照者（30.71±19.59 vs 21.39±14.98,P〈0.05）.（2）血清ALT活性正常的MHO个体发生NAFLD的风险较正常对照组明显增加（55%vs 5.71%,OR=20.167,95%CI：8.594~47.323;P〈0.05）.（3）D组发生NAFLD风险明显增高（80%vs30%,OR=9.333,95%CI：1.193~72.991;P〈0.05）.证明正常范围内较高活性的ALT可预测MHO个体中NAFLD的发生.1367 individuals who underwent routine health examination in the People＇s Hospital of Hunan Province from April 2006 to January 2010 were followed up during 1 ~ 3 years.The level of ALT between MHO,Obesity with MS and normal controls was compared.MHO individuals with normal ALT（n = 40） were divided into four groups according to the quartile of ALT（A,B,C,D）,and the incidence of occurrence of NAFLD in MHO individuals in follow-up four groups and the risk of incident NAFLD in different groups of quartile of ALT were compared.Results show that the level of ALT in MHO was lower than in obesity with MS（30.71 ± 19.59 vs 38.29 ±20.57,P〈0.05）,and higher than in normal controls（30.71 ± 19.59 vs 21.39 ± 14.98,P〈0.05）.Following up for 1 to 3 years,the risk of NAFLD in MHO with normal ALT was significantly higher than that in normal controls（55% vs 5.71%,OR = 20.167,95% CI：8.594 ~ 47.323; P〈0.05）.The incidence of NAFLD in the upper quartiles of ALT（D） were significantly increased than that in A（80% vs 30%,OR = 9.333; 95% CI：1.193 ~ 72.991,P〈0.05）.It indicated that even in the normal range,the elevated ALT could predicte the risk of incident NAFLD in MHO.

关 键 词：肥胖 代谢正常肥胖(MHO) 谷丙转氨酶(ALT) 非酒精性脂肪性肝病(NAFLD) 代谢综合征(MS) 

分 类 号：R575.5[医药卫生—消化系统]