血清γ-谷氨酰转肽酶水平与动脉硬化的相关性研究

The association between serum gamma-glutamyltansferase levels and arteriosclerosis

目的:研究血清γ-谷氨酰转肽酶(GGT)水平与动脉硬化的相关性。方法:在上海市嘉定区40岁及以上居民中进行问卷调查、体格检查、生化检测以及肱-踝动脉脉搏波传导速度(baPWV)测量,对其中数据完整的1 594名居民进行分析。baPWV值>1 753 cm/s定义为动脉硬化。采用多元线性回归法分析血清GGT水平的上升与动脉硬化的相关性。结果:该研究人群中男性和女性周围动脉硬化的患病率分别为23.64%和25.61%。baPWV与血清GGT水平呈正相关(男性:r=0.11,P=0.011 9;女性:r=0.23,P<0.000 1)。随着血清GGT水平的升高,baPWV值随之升高;男性和女性动脉硬化的患病率从第1个GGT四分位至第4个GGT四分位分别为18.71%、20.57%、22.70%、32.00%和15.06%、23.02%、27.27%、37.07%,组间趋势显著(男性:趋势P=0.007 6;女性:趋势P<0.000 1)。多元线性回归分析显示,在校正了主要代谢指标及吸烟和饮酒史后,随着GGT的递增,baPWV值仍随之增加。结论:血清GGT水平上升与周围动脉硬化程度升高存在显著且独立的相关性。

Objective To study the association between level of serum gamma-glutamyhansferase （GGT） and arte- riosclerosis in middle-aged and elderly Chinese population. Methods Two thousand five hundred and nineteen subjects aged 40 years or older from Jiading district, Shanghai were recruited to undergo questionnaire interview, anthropometric measurements, biochemical evaluation, and brachial-ankle pulse wave velocity （baPWV）measurement. After excluding subjects with known hepatobiliary disease, excess alcohol consumption, missing baPWV or serum GGT data, ankle-brachial index （ABI）〉I.3 or ABI〈0.9, and those with serum alanine aminotransferase （ALT）, aspartate aminotransferase（AST） or GGT more than two times higher than normal, 1 594 subjects were enrolled in final analysis（571 men and 1 023 wom- en）. These subjects were categorized into 4 groups according to GGT quartiles. The association between baPWV and serum GGT level was analyzed by multiple linear regression analysis. Arteriosclerosis was defined as baPWV〉I 753 em/s. Results The prevalences of arteriosclerosis were 23.64% and 25.61% in men and women, respectively. Serum GGT level was positively correlated with baPWV （male ： r=-0.11, P=-0.011 9 ; female ： r=-0.23, P〈0.000 1 ）. From GGT quartile 1 to quar- tile 4, the prevalences of arteriosclerosis in were 18.71% ,20.57% ,22.70% ,32.00% in male and 15.06% ,23.02% , 27.27% ,37.07% in female, respectively （male ：P for trend=0.007 6 ;female ：P for trend〈0.000 1 ）. Multiple linear regres- sion analysis revealed that increase of serum GGT had a significant association with increased of baPWV in both male and female （male：/3＋SE=22.35＋9.81 ,P=0.023 1 ;female ：~＋_SE=20.03＋_8.25 ,P=0.015 4）, even when traditional metabolic risk factors such as smoking and drinking status were adjusted. Conclusions Serum GGT level is a significant and indepen- dent association factor of arteriosclerosis both in men and women.