贵阳市中老年人群肝脏酶学与糖代谢异常关系的横向研究  

A cross-sectional study of the relationship between liver enzyme and glucose metabolism in middle-aged and elderly population in Guiyang

作　　者：马琳 张淼 张巧 彭年春 胡颖 时立新 MA Lin;ZHANG Miao;ZHANG Qiao;PENG Nianchun;HU Ying;SHI Lixin(Department of Endocrine and Metabolic Diseases,Affiliated Hospital of Guizhou Medical University,Guiyang,Guizhou 550004,China)

机构地区：[1]贵州医科大学附属医院内分泌代谢病科,贵阳550004

出　　处：《重庆医学》2018年第27期3557-3564,共8页Chongqing medicine

基　　金：贵州省科技合作计划项目[黔科合LH字(2015)7413号];国家卫生和计划生育委员会2015-2017年国内多中心研究项目(201502007);2016年贵州省临床重点专科培育项目(医政)[SZD-2016-01];2016年国家重点研发计划(2016YFC0901203)

摘　　要：目的探讨贵阳市中、老年人群中肝脏转氨酶与糖代谢异常的关系。方法于2011年3-8月选取贵阳市云岩区居住5年以上,年龄大于或等于40岁的常驻居民共10 140例,检测丙氨酸氨基转移酶(ALT)、γ-谷氨酰转肽酶(GGT)、天冬氨酸氨基转移酶(AST)、血糖、血脂等指标。对肝酶按4分位分组,多元Logistic回归分析不同肝酶水平与空腹血糖受损(IFG)、糖耐量减低(IGT)、新发糖尿病(NOD)患病之间的关系。结果多元Logistic回归分析表明,校正了年龄、糖尿病家族史、吸烟史、饮酒史、是否规律运动、体质量指数(BMI)、腰围、臀围、收缩压(SBP)、舒张压(DBP)、三酰甘油(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)及胰岛素抵抗指数(HOMA-IR)后,在男性中:ALT最高组(Q4组)NOD患病风险增加[OR=2.806(1.362~5.782)];GGT最高组IGT及NOD患病风险均增加[OR=1.939(1.223~3.073);OR=2.244(1.099~4.582]。在女性中:ALT最高组IGT及NOD患病风险均增加[OR=1.310(1.035~1.658);OR=1.567(1.030~2.383)]。GGT最高组IGT及NOD患病风险均增加[OR=1.492(1.170~1.901);OR=1.941(1.233~3.053)]。无论性别,ALT、GGT、AST与IFG均无相关性(P>0.05)。结论在贵阳市中老年人群中,血清ALT、GGT水平增高者NOD患病风险增加;GGT水平增高者IGT患病风险增加;而仅在女性中ALT水平升高是IGT患病的危险因素。Objective To investigate the relationships between impaired fasting glucose(IFG),impaired glucose tolerance(IGT)and new-onset diabetes mellitus(NOD)with the elevated serum aminotransferase activities in middle-aged and elderly people in Guiyang city.Methods A total of 10 140 residents aged 40 and over who lived in Yunyan District of Guiyang city for more than 5 years were selected from March to August 2011,with serum alanine aminotransferase(ALT),gamma-glutamyl transpeptidase(GGT),aspartate aminotransferase(AST),blood glucose,blood lipids indicators were tested.Then the values of ALT,GGT AST were divided into four groups according to interquartiles range to analyze the associations of these 3 aminotransferases with IFG,IGT and NOD by multivariate logistic regression analysis.Results Multivariate logistic regression analysis showed that after adjusting for confounding factors.NOD risk increased in ALT highest group[OR=2.806(1.362-5.782)],IGT and NOD risk increased in GGT highest group[OR=1.939(1.223-3.073);OR=2.244(1.099-4.582)],and IGT and NOD increased risk in ALT highest group[OR=1.310(1.035-1.658);OR=1.567(1.030-2.383)]in males;IGT and NOD risk increased in GGT highest group[OR=1.492(1.170-1.901);OR=1.941(1.233-3.053)]in female.Gender,ALT,GGT and AST had no correlation with IFG(P>0.05).Conclusion The risk of NOD increased in patients with elevated serum ALT and GGT levels of middle-aged and elderly people of Guiyang,elevated GGT levels can increase the risk of IGT prevalence,and only in female the elevated ALT levels is a risk factor of IGT prevalence.

关 键 词：葡糖耐受不良 新发糖尿病 丙氨酸转氨酶 Γ-谷氨酰转肽酶 天冬氨酸氨基转移酶类 

分 类 号：R575[医药卫生—消化系统]