γ-谷氨酰转移酶与代谢综合征及各组分的相关性研究

Relationship between γ-glutamyl Transferase Enzyme and the Metabolic Syndrome

目的探讨γ-谷氨酰转移酶(GGT)对代谢综合征(MS)及其各组分的影响。方法选取2007—2010年每年来我院健康体检中心体检的471例铁道部机关在职人员,2007年共检出MS 118例(25.1%)。纳入后每年随访1次,连续3年,每年测量身高、体质量、腰围(WC)、血压,计算体质指数(BMI),检测总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)、空腹血糖(FPG)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、GGT、空腹胰岛素(FINS),计算胰岛素抵抗指数(HOMA-IR)。结果 (1)MS组的男性比例、年龄、WC、血压、TC、TG、FPG、HOMA-IR、ALT、AST、ALP、GGT水平均高于非MS组,HDL水平低于非MS组,差异均有统计学意义(P<0.05)。(2)以2010年MS作为应变量,2007年ALT、AST、ALP、GGT水平作为自变量,Logistic回归分析显示,GGT与MS具有相关性〔OR=1.041,95%CI(1.020,1.063)〕。(3)根据2007年非MS组GGT水平的四分位分为Q1组<14 U/L,Q2组14～20 U/L,Q3组21～30 U/L,Q4组>30 U/L,以2010年MS作为应变量,进行发病风险的比较,模型1(未调整)和模型2(调整年龄、性别)中Q3组和Q4组与Q1组比较,差异均有统计学意义(P<0.05);模型3(模型2加调整BMI、WC、ALT)中Q4组与Q1组比较,差异有统计学意义(P<0.05);模型4(模型3加调整TG、HDL)和模型5(模型4加调整HOMA-IR)中组间比较,差异均无统计学意义(P>0.05)。(4)不同GGT水平者MS及其各组分发病风险比较,结果显示,以TG和血压为应变量时Q2组、Q3组和Q4组与Q1组比较,差异均有统计学意义(P<0.05);以WC、FPG为应变量时Q3组和Q4组与Q1组比较,差异均有统计学意义(P<0.05);以HDL为应变量时组间比较,差异无统计学意义(P>0.05)。结论 GGT与MS的发生存在一定相关性,同时随着GGT水平的升高,WC、TG、血压、FPG升高的风险也增加。

Objective To analyze the characteristics of various liver enzymes in patients with metabolic syndrome,and to explore the relationship between γ - glutamyl transferase enzyme and the metabolic syndrome. Methods 471 cases receiv-ing physical examination in our hospital from 2007 to 2010 were enrolled and followed up once a year for three years. Their height,weight, waist circumference （ WC） and blood pressure （BP） were recorded. Alanine aminotransferase （ ALT） , aspartate amin-otransferase （AST ） , alkaline phosphatase （ ALP ） , γ - glutamyl transferase （ GGT ） , total cholesterol （ TC ） , triglyceride（TG） , high - density lipoprotein （ HDL） , low - density lipoprotein （ LDL） , fasting blood glucose （ FBG） , fasting insulin（FINS） were examined and body mass index （ BMI）,insulin resistance index （ HOMA - IR） were also calculated. Results（1 ） Compared with the non - metabolic syndrome group, the proportion of male, age, WC, BP, TC, TG, FPG, HOMA -IR, ALT, AST, ALP and GGT were significantly higher and the level of HDL was significantly lower in metabolic syndromegroup （P 〈0. 05） . （2） GGT was associated with MS [ OR = 1. 041, 95% CI （1.020, 1.063）〕in logistic regression model inwhich MS in 2010 was regarded as the dependent variable and ALT, AST, ALP, GGT level in 2007 were regarded as the inde-pendent variable. （3） The level of GGT within non - metabolic syndrome group in 2007 was divided into quartiles〔 Q1 group（GGT 〈 14 U/L） , Q2 group （GGT within 14 - 20 U/L） , Q3 group （GGT within 21 -30 U/L） , Q4 group （GGT 〉 30 U/L）〕and MS in 2010 was regarded as the dependent variable, and then the comparison of the risk factors were performed. The resultsuggested that the level of GGT was higher in Q3 and Q4 group than Q1 group in modell and model2, showing statistically significant differences （P 〈 0. 05 ） , and the level of GGT was higher in Q4 group than Q1 group in model3 , also showing statisticallysignificant difference （P 〈0. 05） , and there were no different in model4 and model5. （4） Logistic regression analysis was performed between different levels of GGT and WC, TG, HDL, BP and FPG. The results showed that compared with Q1 group,Q2 , Q3 and Q4 groups showed statistically significant differences when TG and BP being the dependent variables （ P 〈 0. 05 ）.And compared with Q1 group, Q3 and Q4 groups showed statistically significant differences when WC and FPG being the depend-ent variables （ P 〈 0. 05 ） . However, when HDL being the dependent variable, the difference was not statistically significant （ P〉 0. 05 ）. Conclusion γ- glutamyl transferase enzyme level was associated with metabolic syndrome. The risk of WC, TG, BPand FPG will rise with the increase of GGT level.