2型糖尿病合并代谢综合征患者肝酶变化及相关性研究

The correlation of liver enzymes and metabolic syndrome in newly diagnosed type 2 diabetes mellitus

目的探讨新诊断的2型糖尿病合并代谢综合征(MS)的患者血清肝酶水平的变化及与代谢综合征各组分的相关性。方法收集该院291例新诊断的2型糖尿病患者,并将其分为MS组、非MS(NMS)组,测量身高、体重、腰围和血压,并计算体重指数(BMI)和腰臀比;采血检测空腹血糖(FBG)、餐后2 h血糖(2h PBG)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、谷氨酰转移酶(GGT)、三酰甘油(TG)、胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹胰岛素(FINS)和餐后2 h胰岛素(2hINS),计算胰岛素抵抗指数(HOMA-IR),并对各指标进行比较分析。结果 MS组ALT、AST、GGT、腰围、BMI、TG、TC、LDL-C、收缩压(SBP)、舒张压(DBP)、HOMA-IR、2h PBG、FINS和2h INS均显著高于NMS组(P<0.05)。Pearson相关分析显示:ALT与BMI、DBP、HOMA-IR、FINS呈正相关(P<0.05);AST与BMI、SBP、DBP、FINS呈正相关(P<0.05);GGT与TG、HOMA-IR、FINS呈正相关(P<0.05)。以HOMA-IR为因变量进行多元逐步回归分析,进入回归方程的因素为BMI、TG和ALT,HOMA-IR与BMI、TG及ALT呈正相关。结论 2型糖尿病合并MS患者血清肝酶水平包括ALT、AST和GGT均明显增高,且以ALT与MS相关最为密切。

[ Objective ] To explore the relationship between liver enzymes and metabolic syndrome （MS） in newly diagnosed type 2 diabetes mellitus. [Methods] 291 patients with newly diagnosed type 2 diabetes were divided into MS group and NMS group. Body Mass Index （BMI）, waist circumference, blood pressure were measured, liver en- zymes, plasma glucose, lipids and insulin were detected, insulin resistance index （HOMA-IR） was calculated accord- ing to the formula. The relationship of liver enzymes and MS in two groups were studied. [ Results ] The results of alanineaminotransferase （ALT）, aspartateaminotransferase （AST）,＇y-glutamyltransferase （GGT）, waist circumference, BMI, systolic blood pressure（SBP）, diastolic blood pressure （DBP）, total cholesterol （TC）, serum triglyceride （TG）, low density lipoprote in cholesterol （LDL-C）, 2 h postprandial plasma glucose （2 h PBG）, fasting and 2 h postprandial in- sulin （FINS and 2 h INS）, HOMA-IR in MS group were significantly increased than that of NMS group （P 〈0.05）. Pearson correlation analysis showed there were positively correlations between ALT and BMI, DBP, HOMA-IR, fast- ing insulin （P 〈0.05）, between AST and BMI, SBP, DBP, fasting insulin （P 〈0.05）, and between GGT and TG, HOMA-IR, fasting insulin （P 〈0.05）. Multiple stepwise regression analysis showed there was a positive correlation between HOMA-IR and BMI, TG and ALT. [Conclusion] The expression of ALT, AST and GGT in newly diag-nosed type 2 diabetic patients with metabolic syndrome were significantly increased, and the ALT had a most closely associated with MS.