血清肝酶水平与老年人群空腹血糖水平的关联:一项回顾性队列研究  

Association between Serum Liver Enzyme Level and Fasting Blood Glucose Level in Elderly Population:A Retrospective Cohort Study

作　　者：马骏 戴威 赵原原 张晓霞 周小琦[2] 李长风[2] MA Jun;DAI Wei;ZHAO Yuanyuan;ZHANG Xiaoxia;ZHOU Xiaoqi;LI Changfeng(Center for Disease Prevention and Control of Qiaokou District,Wuhan,430035,China;不详)

机构地区：[1]硚口区疾病预防控制中心,湖北武汉430035 [2]武汉市疾病预防控制中心,湖北武汉430024

出　　处：《中国社会医学杂志》2025年第2期196-201,共6页Chinese Journal of Social Medicine

基　　金：武汉市卫健委科研项目(WG21Z02)。

摘　　要：目的研究血清丙氨酸氨基转移酶(alanine aminotransferas,ALT)、血清天冬氨酸氨基转移酶(aspartate aminotransferase,AST)与空腹血糖(fasting plasma glucose,FPG)水平、空腹血糖受损(impaired fasting glucose,IFG)、2型糖尿病(type 2 diabetes mellitus,T2DM)检出异常的关联。方法对武汉市某区2012-2018年间体检老年人群建立回顾性研究队列,采用多因素Logistic回归、自回归交叉滞后模型分析ALT、AST与老年人血糖水平异常检出关联。结果在3792名基线人群中,对3190名血糖正常未检出IFG、T2DM人群7年后体检结果进行分析,发现有264人出现IFG,检出率8.28%,151人出现T2DM,检出率4.73%。ALT第2~5组发生空腹血糖异常风险是第1组的1.42倍、1.65倍、2.46倍、3.83倍;AST第5组是第1组风险的1.83倍。基线ALT、AST与后续随访FPG之间的回归系数β分别为0.07和0.73;基线FPG与后续随访ALT、AST间回归系数β分别为0.14和0.50,均P<0.001。结论肝酶与血糖存在双向因果时序关联,高水平AST与血糖异常检出率相关,正常值内ALT水平升高会提高血糖异常检出的风险。Objective To investigate the correlation between two liver enzymes,alanine aminotransferase(ALT)and aspartate aminotransferase(AST)and fasting blood glucose levels,impaired fasting glucose(IFG)and detection of abnormalities in type 2 diabetes mellitus(T2DM).Methods A retrospective cohort was established among the elderly population from 2012 to 2018.Multivariable Logistic regression and autoregressive cross-lag model were used to analyze the association between ALT,AST and abnormal blood glucose levels in the elderly.Results Among the 3792 people,the physical examination results of 3190 people with normal blood glucose without IFG or T2DM were analyzed after 7 years,and 264 people developed IFG,the detection rate was 8.28%.151 people developed T2DM and the detection rate was 4.73%.Regression analysis showed that the risk of IFG in ALT groups 2,3,4 and 5 were 1.42 times,1.65 times,2.46 times,3.83 times higher than those from group 1.The AST-adjusted risk in group 5 was 1.83 times higher than that in group 1.The regression coefficients between baseline ALT,AST and follow-up FPG were 0.07 and 0.73,respectively.The regression coefficients between baseline FPG and follow-up ALT and AST were 0.14 and 0.50,respectively,with P<0.001 for all of them.Conclusion A bidirectional causal temporal association was observed between liver enzymes and blood glucose.High AST levels are associated with the detection rate of abnormal blood glucose.Elevated ALT levels in the normal range also increase the risk of abnormal blood glucose detection.

关 键 词：丙氨酸氨基转移酶 天冬氨酸氨基转移酶 空腹血糖 老年人 回顾性队列 自回归交叉滞后模型 

分 类 号：R587.1[医药卫生—内分泌]