健康体检人群γ谷氨酰转肽酶与代谢综合征关联的队列研究

Analysis of association between γ-glutamyltransferase and risk of metabolic syndrome in health checkup cohort

目的：评估人群血清谷氨酰转肽酶（GGT）与代谢综合征（MS）关联性。方法采用历史性队列研究方法，对深圳市4935名健康体检人群进行10年随访，其中男性占81.84%，女性占18.16%；平均年龄（60.54＆#177;10.38）岁。随访结局为MS事件发生，利用Cox比例风险模型计算GGT与MS发生关联强度。结果队列人群平均随访（5.0＆#177;2.9）年，共随访24713人年，发生MS事件1689例，MS累计发病率34.22%，发病密度（ID）68.34/千人年；无论男、女，ID与GGT呈现剂量？反应关系（男：χ2=32.78，P〈0.001；女：χ2=18.80，P〈0.001）；拟合Cox比例风险模型，在调整年龄、性别、体质指数、收缩压、舒张压、高密度脂蛋白、低密度脂蛋白、三酰甘油、血尿酸、空腹血糖后，第3、4四分位数组GGT发病风险为1.45（95%CI：1.08-1.85）和1.52（95%CI：1.15-1.99）。结论 GGT水平与MS之间存在关联，有可能是MS发生的风险因素及预测因子。

Objective To analyze the relationship between baseline serum γ-glutamyhransferase （GGT） and risk of the metabolic syndrome （MS）. Method A total of 4 935 adults from health checkup population in Shenzhen were enrolled into a 10-year follow-up study, of these adults 81.84% were male and 18.16% were female, the average age was 60.54± 10.38 years.The follow-up outcome measure was the occurrence of MS. The proportional hazards model was adopted to calculate the hazard ratios （HR） and 95% confidence intervals （95% C/） to analyze the association of GGT with the development of MS. Reslut The mean follow up period was 5.0±2.9 years, and there were 24 713 person-years of follow-up, and 1 689 subjects developed MS. During the follow-up, the cumulative incidence and incidence density of MS were 34.22% and 68.34/1 000 person-years, respectively. For both genders, the association between GGT and MS presented dose- response relationship trend （male： M- C X^2=32.78, P〈0.001; female： M- C X^2=18.80, P〈 0.001）. After adjusting for age, gender, body mass index, systolic blood pressure, diastolic blood pressure, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, uric acid and fasting blood glucose in Cox regression model, the HR for MS in quartiles 3 and 4 level of GGT was 1.45 （95%CI： 1.08-1.85） and 1.52 （95%Ch 1.15-1.99）, respectively. Conclusion The GGT level could be an important risk factor and predictor for the development of MS.