社区人群血清肝酶水平与糖代谢异常的相关性  

Relationship between serum hepatic enzymes and abnormal glucose metabolism

作　　者：王丹[1] 张丽娜[1] 徐康[1] 张开金[2] 周玲[1] 

机构地区：[1]南京医科大学公共卫生学院流行病与卫生统计学系,江苏南京211166 [2]东南大学公共卫生学院

出　　处：《实用预防医学》2015年第1期9-12,共4页Practical Preventive Medicine

基　　金：国家自然科学基金项目(70973018);江苏高校优势学科建设工程项目

摘　　要：目的探讨社区人群血清肝酶水平与糖耐量、胰岛素抵抗及胰岛分泌功能的相关性。方法对南京市三个社区的20岁及以上常住居民进行糖尿病筛查,并测定血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)和γ-谷氨酰转肽酶(GGT),合格研究对象共5 375人,平均年龄(58.3±9.4)岁,正常糖耐量(NGT)3 010人、糖调节受损(IGR)1 707人,新诊糖尿病(DM)658人。利用稳态模式法计算HOMA-IR和HOMA-%B。结果非条件Logistic回归分析显示,随着ALT、GGT水平的升高,IGR、DM的患病风险均逐渐增加(P均<0.001),而AST水平与IGR、DM的患病风险无统计学关联(P均>0.05)。多元线性回归分析显示,随着ALT、GGT水平升高,HOMA-IR的平均水平均逐渐升高(标准化回归系数β分别为0.12和0.1,P均<0.001)。随着ALT水平升高,HOMA-%B的平均水平逐渐升高(β=0.05,P=0.003)。未发现GGT与HOMA-%B间存在线性趋势(β=-0.04,P=0.25)。结论 ALT或GGT水平升高可能成为IGR、DM的早期预测指标。Objective To explore whether elevated alanine aminotransferase（ALT）, aspartate aminotransferase（AST）, or γ- glutamyltranspeptidase（GGT） are risk factors for impaired glucose regulation（IGR） or diabetes mellitus（DM） and whether these hepatic enzymes are associated with insulin resistance or insulin secretion in Chinese. Methods Totally, 5,375 people （58.3 ± 9.4 years of age） from three communities in Nanjing City were enrolled in the study, including 3,010 with normal glucose, tolerance （NGT）, 1,707 with IGR and 658 with DM. Their serum ALT, AST and GGT were measured and HOMA IR and HOMA %B were calculated. Results Non conditional Logistic regression analysis showed that, with elevated ALT or GGT, the risk of IGR and DM were both increased gradually （all P 〈 0. 001）, however, AST was not statistically correlated with the risk of IGR and DM. Multiple linear regression analysis showed that, with elevated ALT or GGT, the level of HOMA IR increased gradually （standardized regression coefficient β were 0.12 and 0.1 respectively, both P 〈 0. 001 ）. With elevated ALT, the level of HOMA %B gradually elevated （standardized regression coefficient p= 0.05, P = 0. 003）. Linear trend was not found between GGT and HOMA % B（β = - 0.04, P = 0.25）. Conclusions Elevated ALT and GG-T may be early predictors for IGR and DM.

关 键 词：糖耐量 丙氨酸转氨酶 Γ-谷氨酰转肽酶 胰岛素抵抗 胰岛素分泌 

分 类 号：R587[医药卫生—内分泌]