脂肪肝患者血清丙氨酸氨基转移酶水平与糖代谢、脂代谢、体重指数关系的研究

Study on the relationship between serum alanine aminotransferase levels and glycometabolism,lipometabolism,body weight index in fatty liver disease

目的:调查脂肪肝患者丙氨酸氨基转移酶(Alanine aminotransferase,ALT)水平与糖代谢、脂代谢、体重指数的关系。方法:将2008年体检中心通过B超诊断的17300名脂肪肝患者的丙氨酸氨基转移酶与血脂(总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白)、血糖、体重指数等检测指标的关系进行统计分析。结果:脂肪肝患者中ALT异常组的血糖、血脂、体重指数的测定值(均数±标准差)高于ALT正常组,其中两组间血脂、体重指数的差异有统计学意义;两组间血脂、体重指数的异常率亦有显著性差异,血糖的异常率没有显著性差异;多元逐步Logistic回归分析示ALT水平与高密度脂蛋白、低密度脂蛋白、体重指数有相关性。结论:ALT异常是脂肪肝患者常见的临床表现之一,是肝脏炎症程度的重要指标,因ALT水平与脂代谢紊乱和肥胖有相关性,故可通过控制体重、降低血脂,防止脂肪肝炎症程度加重,避免肝功能衰竭的发生。

Objective：To investigate the relationship between serum alanine aminotransferase levels（ALT） and glycometabolism,lipometabolism,body weight index in fatty liver disease.Methods：A total of 17300 subjects who got medical health checkup in our medical examination center in 2008,diagnosed as fatty liver through ultrasound imaging,were enrolled in the study.Statistical analysis was given on the relationship between ALT and lipid（total cholesterol,triglyceride,high density lipoprotein,low density lipoprotein）,fasting plasma glucose（FPG）,body weight index（BMI）.Results：The levels of FPG,lipid,BMI in abnormal ALT group were higher than those in normal ALT group,in which difference in lipid and BMI has statistical significance;the abnormal rate of lipid and BMI between two groups has significant difference also,except the abnormal rate of FPG has no significance.Moreover,in the multiple stepwise regression analysis,there were statistically significant correlations between ALT levels and high density lipoprotein,low density lipoprotein,BMI.Conclusion：Abnormality of ALT is not only common clinical manifestation of fatty liver,but also the important marker of inflammation of fatty liver.ALT levels of nonalcoholic fatty liver is related with obesity and hyperlipid.It may ameliorate the progression of the inflammation of fatty liver and prevent the liver failure by keeping fit weight and lowering of body lipid.