2型糖尿病患者正常血清丙氨酸氨基转移酶水平与能量代谢综合征相关性的研究

Association of serum alanine aminotransferase in normal ranges with metabolic syndrome in T2DM patients

目的探讨T2DM患者正常范围内血清丙氨酸氨基转移酶(ALT)水平与MS的相关性。方法选取319例ALT水平正常的T2DM患者按四分位数分为4组(Q1～4组),分析ALT水平与MS组间差异及其组分的关系。结果随ALT水平升高,T2DM患者BMI、TG、SUA和胰岛素抵抗指数(HOMA-IR)均逐渐升高(趋势P<0.05),且TG、HOMA-IR与ALT呈独立相关;MS、肥胖、高甘油三酯血症的患病率随ALT的升高而升高(趋势P<0.001)。Q1～4组,MS患病率分别为41.5%、47.2%、54.9%和65.9%。ALT水平与MS及其多数组分的患病风险有相关性。与Q1组比,Q4组MS患病风险增加232%,肥胖风险增加138%,高血压风险增加175%,高甘油三酯血症风险增加256%。结论 T2DM患者正常范围内血清ALT水平与MS及其组分密切相关。

Objective To investigate the association between serum alanine aminotransferase （ALT） in normal ranges and MS in T2DM patients. Methods A total of 319 T2DM subjects with normal ALT levels were recruited to undergo anthropometric measurements and fasting biochemical assay such as blood glucose, lipid, uric acid and insulin. The subjects were divided into four （Q1-4） groups according to the quartiles of ALT, comparing the differences of metabolic indexes among them and analyzing the association between ALT levels and metabolic syndrome. Results BMI, TG, UA, and HOMA-IR were gradually elevated with the increase of ALT concentration （P〈0. 05）. Moreover, trigiyceride and HOMA-IR were independent factors of ALT levels change. The prevalence of MS, obesity, and hypertriglyceridemia was getting higher with the increase of ALT levels （P〈0. 001）. In Q1-4 groups, the prevalence of MS was 41.5%, 47. 2%, 54. 9%, and 65.9% respectively. ALT levels were also correlated with the risks of MS and most of its components. Compared with the Q1 group, the risks of MS, obesity,＇ hypertension, and hypertriglyceridemia in the Q4 group were increased by 232%, 138%, 175% and 256% respectively. Conclusion Serum ALT level in normal ranges is significantly associated with MS and its opponents in T2DM.