血清肝酶水平联合乙醇摄入量预测2型糖尿病发病的价值

Predictive value of liver enzymes and alcohol consumption for risk of type 2 diabetes

目的 探讨血清肝酶联合乙醇摄入量对2型糖尿病（T2DM）发病的预测价值. 方法 选取郑州市社区调查的2 693名男性,记录其身高、体质量、吸烟史、饮酒史,检测血清ALT、AST、y-谷氨酰转移酶（GGT）、血糖及相关代谢指标.两组间均数比较采用独立样本t检验,率的比较采用x^2检验;两组间连续性变量应用Pearson相关分析,等级变量应用Spearman相关分析;参数分析采用二项分类logistic回归分析. 结果 适度饮酒（每周摄入乙醇量＞35g且＜140 g）减少T2DM的发病风险[比值比（OR）=0.376,95％可信区间（CI）为0.306～ 0.463,P＜0.05）].血清GGT和ALT水平升高增加T2DM的发病风险（GGT：OR-3.012,95％ CI为2.357 ～ 3.849,P＜0.01;ALT：OR=1.473,95％ CI为1.043 ～ 2.081,P＜0.05）.不饮酒或少量饮酒（每周摄入乙醇量≤35 g）且GGT位于第四分位间距水平组发生T2DM的风险最高（OR=12.219,95％CI为6.217 ～ 24.016,P＜0.01）.ALT和乙醇摄入量与T2DM发病之间的关系和GGT类似（不饮酒或少量饮酒且ALT位于第四分位间距水平组,OR=5.357,95％ CI为3.070 ～ 9.350,P＜0.01）. 结论 GGT、ALT、乙醇摄入量分别与T2DM发病相关.不饮酒或少量饮酒而GGT或ALT升高者发生T2DM的相对危险较高.

Objective To compare the predictive value of liver enzymes and alcohol consumption for determining risk of type 2 diabetes （T2DM）.Methods A cross-sectional study was conducted in Zhengzhou with a total of 2,693 men.Participants＇ height,weight,and histories of smoking and drinking were recorded.Levels of alanine aminotransferase （ALT）,aspartate aminotransferase （AST）,γ-glutamyl transferase （GGT） and blood glucose,as well as related metabolic indexes were detected.Results Moderate daily alcohol consumption （＞ 35 g ethanol/week and ＜ 140 g ethanol/week） decreased the risk of type 2 diabetes （OR =0.376,95％ CI：0.306 -0.463,P ＜ 0.05） but increased risk for higher levels of GGT and ALT （OR GGT =3.012,95％ CI：2.357-3.849,P＜ 0.01; ORALT =1.473,95％ CI：1.043-2.081,P＜ 0.05）.In joint analyses of alcohol consumption and liver enzymes,the group of nondrinkers/light drinkers （≤ 35 g ethanol/week） in the fourth quartile of GGT levels had the highest risk for type 2 diabetes （OR =12.219,95％ CI：6.217-24.016,P ＜ 0.01）.The relationship of ALT and daily alcohol consumption with the risk of type 2 diabetes was almost the same as that of GGT （nondrinkers/light drinkers in the fourth quartile of ALT levels （OR =5.357,95％ CI：3.070-9.350,P ＜ 0.0 1）.Conclusion GGT,ALT and daily alcohol consumption were independently associated with risk of type 2 diabetes.Nondrinkers/light drinkers with the highest levels ofGGT orALT were at high risk of type 2 diabetes.