ALT水平与糖尿病患者糖脂代谢水平的关系研究

Relationship of ALT levels and levels of glucose and lipid metabolism in diabetic patients

目的探讨2型糖尿病患者(T2MD)血清丙氨酸氨基转移酶(ALT)水平与糖脂代谢水平的关系。方法2012年1月至2014年1月选取本院健康管理中心体检的68例T2MD患者为研究对象,另选取同期在本院进行葡萄糖耐量试验(OGTT)试验的128例体检者为对照组,根据OGGT试验将体检者分为糖耐量减低组(IGT)60例以及血糖正常组(NGT)组。测定三组血清ALT、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)、三酰甘油(TG)、总胆固醇(TC)、低密度蛋白(LCL-C)、高密度蛋白(HCL-C)、载脂蛋白B(APOB)、载脂蛋白A1(APOA1),并计算各组体质指数(BMI)及胰岛素抵抗指数(HOMA-IR)。采用Pearson直线相关性分析ALT与IR的关系,Logistic多因素回归分析ALT与HOMA-IR的关系。结果 T2MD组患者血清ALT、FBG、HbA1c、FINS、TG、TC、LCL-C、APOB、HOMA-IR水平显著高于IGT组及NGT组,而IGT组上述各指标高于NGT组,而HCLC、APOA1水平显著低于IGT组及NGT组,差异有统计学意义(P<0.05)。经Pearson相关分析可知,血清ALT与FINS、FBG、HbA1c、APOB、LCL-C、HOMA-IR呈正相关(P<0.05),而与APOA1呈负相关(P<0.05),与TG、TC、HCL-C无相关性(P>0.05)。Logistic多因素回归分析表明,ALT、FBG、HbA1、、LCL-C是HOMA-IR的独立危险因素。结论血清ALT升高与T2MD的发生具有密切的关系,且这种关系可能与血脂血糖及胰岛素分泌功能相关。

Objective To investigate the relationship between the levels of type 2 diabetes mellitus （T2MD） ser‐um alanine aminotransferase （ALT） and levels of glucose and lipid metabolism .Method 68 cases of Endocrinology T2MD patients were selected for the study from January 2012 to January 2014 .128 cases of period were divided into the groups with impaired glucose tolerance （IGT ,n=60） and normal glucose group （NGT ,n=68） accord to glu‐cose tolerance test （OGTT）.The levels of serum ALT ,fasting blood glucose （FBG）,glycated hemoglobin （HbA1c） ,fasting insulin （FINS） ,triglyceride （TG） ,total cholesterol （TC） ,low‐density protein （LCL‐C） ,high density protein （ HCL‐C） ,apolipoprotein B （APOB） ,apolipoprotein A1 （APOA1） ,and calculate the body mass index of each group （BMI） and insulin resistance index （HOMA‐IR） of three groups were compared .Logistic re‐gression of the relationship was analyzed between the FFA and HOMA‐IR by using the straight‐line relationship be‐tween the Pearson correlation analysis of ALT and IR .Result The levels of serum ALT patients ,FBG ,HbA1c , FINS ,TG ,TC ,LCL‐C ,APOB ,HOMA‐IR of T2MD groups were higher than IGT group and NGT group ,while each of the above indicators higher than the IGT group NGT group ,while HCL‐C ,APOA1 were significantly low‐er than IGT group and the NGT group ,the difference was statistically significant （P〈0 .05） .By Pearson correla‐tion factor analysis ,serum ALT and FINS ,FBG ,HbA1c ,APOB ,LCL‐C ,HOMA‐IR was positively correlated （P〈0 .05） ,whereas the APOA1 negatively correlated （P〈0 .05） ,and TG ,TC ,HCL‐C no correlation （P〉0 .05） . After Logistic regression analysis shows ,ALT ,FBG ,HbA1 ,LCL‐C was an independent risk factor for HOMA‐IR .Conclusion Serum ALT elevations occurred with T2MD has a close relationship ,and this relationship may be as‐sociated with blood lipid and glucose and insulin secretion .