40岁以上人群肝酶与代谢综合征和代谢综合征前期的关系研究  

Association of liver enzymes with metabolic syndrome （MS） and pre-MS in adults aged over 40 years old

作　　者：黄秋岚 张皎月[1] 曾天舒[1] 胡祥[1] 闵洁[1] 彭苗苗[1] 万丽敏[1] 陈璐璐[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院内分泌科,武汉430022

出　　处：《中华内分泌代谢杂志》2015年第10期860-864,共5页Chinese Journal of Endocrinology and Metabolism

基　　金：基金项目：科技部国家临床医学研究中心基金（2013BA109813）;科技部重大新药创制基金（2012ZX09303006-001）;湖北省公益性科技研究（2012DCA12003）;湖北省科技支撑计划项目（2013BCB016）

摘　　要：目的探讨人群代谢综合征及代谢综合征前期与肝酶水平的关系。方法调查宜昌市夷陵地区40岁以上人群9418人，检测血清肝酶[丙氨酸转氨酶（alanine transaminase，ALT）、门冬氨酸氨基转移酶（aspartate aminotransferase，AST）、γ-谷氨酰转移酶（γ-glutamyltransferase，GGT）]、总胆固醇、甘油三酯、高密度脂蛋白胆固醇（high—density lipoprotein—cholesterol，HDL—C）、血糖等指标。结果GGT异常与除了高空腹血糖外的代谢综合征其他组分均密切相关（P〈0．05），代谢综合征前期仅与GGT异常相关[OR（95％CI）=1．27（1．00—1．61）]；代谢综合征则与GGT异常关系最为密切[OR（95％CI）=3．03（2．35～3．92）]，其次为ALT异常和AST异常（P〈0．05）。受试者工作特征（ROC）曲线分析显示GGT[曲线下面积（AUC）为0．638]用于筛查代谢综合征患病可能性的价值大于ALT（AUC为0．575）。结论GGT水平的升高与代谢综合征前期和代谢综合征关系最为密切。即使正常范围内的GGT、ALT水平升高也与代谢综合征患病密切相关。Objective To explore the relationship of metabolic syndrome（MS） and pre-MS with serum liver enzymes. Methods A total of 9 418 individuals aged over 40 years old were enrolled in the cross-sectional survey in Yiling District of Yichang City. The levels of alanine transaminase （ ALT）, aspartate aminotransferase （ AST）, γ- glutamyhransferase（ GGT）, total cholesterol （ TC ）, triglycerides （ TG ）, high-density lipoprotein-cholesterol （ HDL- C ） , and blood glucose were tested. Logistic regression was performed to explore the OR for the prevalence of MS in the individuals with abnormal liver enzymes. ROC curve was used to analyze the predictive values of abnormal liver enzymes for the prevalence of MS. Results Abnormal ALT showed a close relationship with hypertension, high fasting plasma glucose （ FPG）, and high TG ; while abnormal AST was only associated with hypertension and high TG. However, abnormal GGT represented close associations with all MS components except high FPG, and showed the closest relationship with high TG （ P〈0.05 ）. Moreover, pre-MS was only associated with abnormal GGT [ OR （ 95 % CI） = 1.27 （ 1.00-1.61 ） ], while MS was more closely correlated with abnormal GGT[ 0R（95% CI） = 3.03 （2.35- 3.92） ] than abnormal ALT or AST（ all P〈0.05 ）. In the receiver operating characteristic curve （ ROC curve）, the GGT[ area under curve （ AUC ） = 0. 638 ] was more valuable to screen the possible prevalence of MS than ALT does （ AUC = 0. 575, P〈0.05 ）. Conclusion Abnormal GGT level shows a closest correlation with the onset of pre-MS and MS. Even within the normal range, the elevation of serum GGT and ALT are still associated with the prevalence of MS.

关 键 词：肝酶 代谢综合征 

分 类 号：R589[医药卫生—内分泌]