糖尿病患者γ-谷氨酰转移酶的变化及其与血脂的关系

Change in serum gamma-glutamyltransferase in diabetic patients and its relationship with blood lipids

目的探讨2型糖尿病患者血清γ-谷氨酰转移酶(GGT)的变化,分析GGT与血脂指标的关系。方法对560例2型糖尿病患者测定血清GGT、空腹血糖、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)。根据GGT测定值分为4级,即Ⅰ级小于18 U/L;Ⅱ级18～25 U/L;Ⅲ级26～39 U/L;Ⅳ级大于或等于40 U/L,分析与血脂的关系。结果560例中GGT升高者136例,异常率为24.28%,男性患者GGT异常率为26.52%,女性患者异常率为21.46%,男女患者间GGT异常率差异无统计学意义(t=1.64,P>0.05)。糖尿病患者GGT升高的特点,多数为轻度升高,约1/4的患者GGT升高超正常值两倍以上。GGT升高组TG水平[(2.85±3.26)mmol/L]明显高于GGT正常组[(1.85±1.56)mmol/L],差异有统计学意义(t=4.824,P<0.001)。分级分析表明,男性和女性患者血清TG水平均随GGT升高而增高,不同组间TG水平差异有统计学意义(F=5.891、7.721,P<0.001)。相关分析,GGT水平与TG水平呈正相关(r=0.231 8,P<0.01),而其他血脂项目,不同GGT水平组间差异无统计学意义(P均>0.05)。结论2型糖尿病患者伴血清GGT升高者较多见,GGT与TG密切相关,TG水平随GGT升高而增高,两者呈平行关系。GGT和TG的增高可能均为糖尿病的危险因素。

Objective To investigate the change of serum gamma-glutamyltransferase （GGT） in type 2 diabetic patients and its relationship with blood lipids. Methods Serum GGT,fasting blood glucose, total cholesterol （TC）, triglyceride （TG）, high density lipoprotein cholesterol （ HDL-C）, and low density lipoprotein cholesterol （LDL-C） were determined in 560 patients with type 2 diabetic. The results of GGT were classified into four grades： grade Ⅰ： GGT〈18 U/L; grade Ⅱ： GGT 18-25 U/L; grade Ⅲ： GGT 26-39 U/L; grade Ⅳ： GGT≥40 U/L. The relationship of GGT with blood lipids was analyzed. Results Of the 560 patients, 136 （24.28%） had increased GGT. The rate of abnormal GGT was 26.52% in males and 21.46% in females （t= 1.64,P〉0.05）. Most diabetic patients had mildly increased GGT, and approximately 1/4 patients had a GGT level two times higher than the normal GGT level. The TG level was significantly higher in the increased GGT group [（2.85 ± 3.26） mmol/ L] than the normal GGT group E（1.85±1.56）mmol/L] （t：4.824,F〈0.001）.Analyses based on the GGT grades demonstrated that the serum TG level increased with GGT in both male and female patients,and differed significantly between the GGT grades （F=5. 891,7. 721 ,P（0. 001） ; correlation analysis showed a positive correlation between GGT and TG （r = 0.231 8, P〈0.01）. There were no statistical difference between GGT and the other blood lipid parameters in different GGT level groups （P〉0.05）. Conclusion Serum GGT increase is common in type 2 diabetic patients and the GGT level is closely related to the TG level. The TG level increases with the GGT level. Increased GGT and TG may he risk factors for diabetes mellitus.