ALT水平与糖尿病患者糖脂代谢水平的关系研究

The 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(T2DM)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:选择68例T2DM患者为研究对象,另选取同期在我院进行葡萄糖耐量试验(OGTT)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)、低密度脂蛋白(LCL-C)、高密度脂蛋白(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(HOMAIR)。采用Pearson直线相关性分析ALT与IR的关系,Logistic多因素回归分析FFA与HOMAIR的关系。结果:T2DM组患者血清ALT、FBG、HbA1c、FINS、TG、TC、LCL-C、APOB、HOMAIR水平显著高于IGT组及NGT组,而IGT组上述各指标高于NGT组,而HCL-C、APOA1水平显著低于IGT组及NGT组(P<0.05)。经Pearson单因素显示:血清ALT与FBG、FINS、HbA1c、LCL-C、HOMA-IR、APOB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)。经Logistic多因素回归分析可知:ALT、FBG、HbA1、LCL-C是HOMA-IR的独立危险因素。结论:血清ALT升高与T2DM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 2diabetes mellitus（T2DM）serum alanine aminotransferase（ALT）and levels of glucose and lipid metabolism.Methods：68cases of Endocrinology T2 DM patients were selected for the study from January 2012 to January 2014.128 cases of period weredivided into the groups with impaired glucose tolerance（IGT,n=60）and normal glucose group（NGT,n=68）accord to glucose 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.Using the straight-line relationship between the Pearson correlation analysis of ALT and IR,Logistic regression analysis of the relationship between the FFA and HOMA-IR.Results：The levels of serum ALT patients,FBG,HbA1 c,FINS,TG,TC,LCL-C,APOB,HOMA-IR of T2 DM 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 lower than IGT group and the NGT group,the difference was statistically significant（P〈0.05）.By Pearson correlation factor analysis,serum ALT and FINS,FBG,HbA1 c,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 is an independent risk factor for HOMA-IR.Conclusion：Serum ALT elevations occurred with T2 DM has a close relationship,and this relationship may be associated with blood lipid and glucose and insulin secretion.