血清γ-谷氨酰转肽酶与糖代谢水平的相关性研究  

Correlation between serum gamma-glutamyltranspeptidase level and status of glucose metabolism

作　　者：赵楠[1] 蔡艳鹤[1] 甄东户[1] 关聪会[1] 尹鸿涛[1] 杨芳[1] 汤旭磊[1] 

机构地区：[1]兰州大学第一医院内分泌科,甘肃兰州730000

出　　处：《诊断学理论与实践》2016年第4期382-387,共6页Journal of Diagnostics Concepts & Practice

基　　金：甘肃卫生行业科技计划(GSWST2010-03);兰州市城关区科技计划(2013-7-4)

摘　　要：目的：探讨中老年人群中不同糖代谢水平者的血清γ-谷氨酰转肽酶（gamma-glutamyltranspeptidase,GGT）水平差异,并分析其与糖尿病前期[即糖调节受损（impaired glucose regulation,IGR）]及糖尿病（diabetes mellitus,DM）患病风险间的关系。方法：采用整群抽样的方法,对甘肃省兰州市五泉铁路西村社区40~75岁的常住居民进行问卷调查、体格检查和生化检测;将人群分为正常糖耐量（normal glucose tolerance,NGT）组、IGR组及DM组,比较3组人群血清GGT水平的差异,并分析GGT水平与IGR及DM患病风险间的关系。结果：1DM组的GGT水平明显高于NGT及IGR组（P均〈0.01）。协方差分析显示,校正性别、年龄、饮酒等多种影响因素后,DM组的GGT水平仍明显高于NGT及IGR组（P均〈0.01）。2Spearman相关分析显示,血清GGT水平与三酰甘油（triglyceride,TG）、腰围和餐后2 h血糖（two hours postprandial blood glucose,2h PG）的关系较为密切（r值分别为0.357、0.312、0.280,P均〈0.01）;校正性别、年龄、体质量指数、腰围和饮酒的影响后,血清GGT水平与血糖指标（空腹血糖、2h PG、糖化血红蛋白）、血脂指标（低密度脂蛋白胆固醇、总胆固醇、TG）呈正相关（P均〈0.01）。3Logistic回归分析显示,IGR、DM患病风险随着血清GGT水平的升高而增加,校正多种影响因素后,GGT〉69 u/L组的IGR患病风险是GGT四分位水平最低组的2.296倍（95%CI为1.062~4.967,P〈0.05）,且其DM患病风险是GGT四分位水平最低组的4.399倍（95%CI为2.020~9.579,P〈0.01）。结论：甘肃省兰州市五泉铁路西村社区40~75岁常住居民中,血清GGT水平异常者的IGR患病风险升高,且随着血清GGT水平的升高,DM患病风险亦增加,而GGT异常者的DM患病风险升高明显。结果提示该人群中血清GGT水平异常与糖代谢异常患病风险升高显著相关。Objective： To investigate the correlation of serum gamma-glutamyltranspeptidase （GGT） level with status of glucose metabolism and study the association between the GGT level and risk of impaired glucose regulation （IGR） and diabetes mellitus （DM）. Methods： A cluster sampling study was performed in community residents aged 40-75 years in Wuquan Railway West Village Community in Lanzhou. All the participants had completed the questionnaire survey, physi- cal examination and the related biochemical examination. The subjects were divided into three groups according to the status of glucose metabolism： normal glucose tolerance （NGT）, IGR and DM. Serum GGT levels of the three groups were compared, and the correlations between serum GGT and the prevalences of IGR and DM were analyzed. Results： The subjects with DM had a higher serum GGT level than subjects with IGR or NGT （P〈0.01）. After adjustment for sex, age, alcohol consumption and other confounding variables, analysis of covariance indicated that the subjects with DM had a higher serum GGT level than those with IGR and NGT （P〈0.01）. Spearman correlation analysis indicated that serum GGT was correlated with triglyceride （TG）, waist circumference （WC）, postprandial blood glucose （2hPG）（r=0.357, 0.312, 0.280, P all〈0.01）. After adjustment for gender, age, body mass index, WC, and alcohol intake, the level of serum GGT was posi- tively correlated with fasting plasma glucose, 2hPG, HbAlc and low density lipoprotein cholesterol, total cholesterol, TG （P all 〈0.01）. Logistic regression analysis indicated that prevalence of IGR and DM increased with the increase of the serum GGT level. The prevalence of IGR for the top quintile was 2.296 times of that for the bottom one （OR 95%CI 1.062-4.967, P〈0.05）, and the prevalence of DM for the top quintile was 4.399 times of that for the bottom one （OR 95%CI 2.020- 9.579, P〈0.01）. Conclusions： The prevalence of IGR increases in subjects with serum GGT level ov

关 键 词：Γ-谷氨酰转肽酶 糖调节受损 糖尿病前期 糖尿病 横断面研究 

分 类 号：R589.1[医药卫生—内分泌]