血清丙氨酸氨基转移酶升高在非酒精性脂肪肝病中的意义

Upregulation of Serum Alanine Aminotransferase Level and Its Significance in Non-Alcoholic Fatty Liver Disease

目的:评价非酒精性脂肪肝(NAFLD)患者血清丙氨酸氨基转移酶(ALT)升高的意义,从而为非酒精性脂肪肝防治提供更多的理论依据。方法:本研究对象均为2010-2011年在本院进行体检的武汉大学教职员工,内容包括询问病史、体格检查、生化检查、肝脏彩超检查。进一步将NAFLD组病例分成血清ALT升高组和正常组,分析两组的生化指标及相关合并症的患病率,采用二分类Logistic回归分析评价NAFLD患者发生血清ALT升高的危险性。结果:ALT升高组较ALT正常组的体质量指数(BMI)、空腹血糖(FBG)、甘油三酯(TG)、总胆固醇(TC)值高,有统计学差异(P<0.05);NAFLDALT升高组的高甘油三酯血症、高血糖、超重、腹型肥胖患病率较非酒精性脂肪肝ALT正常组升高,有统计学差异(P<0.001);Logistic回归分析显示TG、FBG、BMI与非酒精性脂肪肝患者ALT水平升高密切相关。结论:NAFLD患者ALT水平升高与高甘油三酯血症、高血糖、超重、及高胆固醇血症密切相关。

Objective： To explore the significance of serum alanine aminotransferase （ALT） elevated in nonalcoholic fatty liver disease （NAFLD）. Methods： The survey was conducted among the staff of Wuhan University from 2010 to 2011 in Hospital of Wuhan University. All the participants provided the clinical data of patient history, clinical examination, anthropometry, laboratory tests and routine liver ultrasonography. The NAFLD patients were selected and divided into two groups including elevated serum ALT and normal serum ALT groups. The biochemical indices and other complicated diseases were compared between the two groups. The binary logistic re- gression analysis was adopted to analyze the risk factors of NAFLD patients with high ALT lev- els. Results.. The NAFLD patients with elevated serum ALT had higher levels of BMI, FBG, TG, and TC than those with normal serum ALT. Logistic regression analysis showed that NAFLD with elevated serum ALT was positively correlated to BMI, FBG, and TG. Conclusion.. The prevalence rate of NAFLD in Wuhan University is relatively high and it is associated with a lot of factors. Elevated ALT levels in patients of NAFLD have close relation to high BMI and triglyceride level.