40岁以上人群肝酶与糖耐量的相关性研究

Study of correlation between liver enzymes and glucose tolerance in subjects older than 40 years of age

目的:探讨社区40岁以上人群肝酶与糖耐量之间的相关性。方法 :入选40～75岁某社区自然人群4 281名,测量身高、体重、腰围、臀围、血压,测定血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、γ-谷氨酰转肽酶(GGT)及血脂,行口服葡萄糖耐量试验(OGTT)。①根据OGTT结果将研究对象分成正常糖耐量(NGT)组、单纯空腹血糖受损(i-IFG)组、单纯糖耐量降低(i-IGT)组、IFG+IGT组和糖尿病(DM)组,比较各组肝酶水平差异;②根据肝酶水平分组,比较各组糖尿病前期(PreDM)和新诊断DM比例;③分析多种因素对糖耐量的影响。结果:①不同糖耐量组间ALT、AST、GGT水平的差异有显著意义(P<0.05);②PreDM、新诊断DM患者比例在不同ALT、GGT水平组之间差异有显著意义,而在不同AST水平组中则无显著差异;③ALT、GGT是i-IGT、IFG+IGT和DM的独立危险因素。结论:ALT、GGT水平与糖耐量密切相关,是PreDM、DM的独立危险因素。

Objective To study the relationship between liver enzymes and glucose tolerance in subjects older than 40 years of age. Methods A total of 4 281 subjects between 40 and 75 years of age in a community-based natural population were enrolled. Height, weight, waist circumference, hip circumference, blood pressure, alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, ~/-glutamyltransferase （GGT） and blood lipids were measured. Oral glucose tolerance test （OGr[＇I＇） was performed and the subjects were divided into five groups according to the results of OGTr, namely, normal glucose tolerance （NGT）, isolated-impaired fasting glucose （i-IFG）, isolated-impaired glucose tolerance （i- IGT）, IFG＋IGT and diabetes mellitus （DM）. Liver enzymes were compared between these groups. The prevalences of prediabetes （PreDM） and newly diagnosed DM in groups with different enzyme levels were compared and the relevant factors affecting glucose tolerance were analyzed. Results ALT, AST and GGT levels increased as the glucose tolerance decreased. Prevalences of PreDM and newly diagnosed DM were significantly different between groups with different levels of ALT and GGT, but no difference was found between groups with different AST level. ALT and GGT were independent risk factors for i-IGT, IFG＋IGT and DM. Conclusions ALT and GGT were correlated significantly with glucose tolerance, and also were the independent risk factors of PreDM and DM.