2型糖尿病一级亲属血清肝酶水平与空腹血糖、胰岛素抵抗的相关性分析

Correlation analysis of serum liver enzymes levels and fasting blood glucose,insulin resistance in the first degree relatives of type 2 diabetes mellitus

目的研究2型糖尿病一级亲属血清肝酶水平与空腹血糖(FPG)、胰岛素抵抗之间的关系。方法将142例2型糖尿病一级亲属根据FPG值分为3组:A组为FPG<6.1 mmol/L 79例,B组为FPG 6.1~mmol/L 32例,C组为FPG≥7.0 mmol/L 31例。所有研究对象均检测血压、FPG、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、谷氨酰转肽酶(GGT)、尿酸(UA)、尿素氮(BUN)、肌酐(Cr)和空腹胰岛素(FINS),并计算胰岛素抵抗指数(HOMA-IR)。结果 A组、B组、C组间的ALT、AST呈升高趋势,但差异无统计学意义(P>0.05);B组、C组的FBG、HOMA-IR、GGT均明显高于A组(P<0.05),其中C组的FBG高于B组(P<0.05)。Spearson相关性分析显示,GGT、ALT及AST均与FBG、HOMA-IR呈正相关性(P<0.05)。多元线性逐步回归分析显示,HOMA-IR与BMI、GGT和TG呈正相关性。结论 2型糖尿病一级亲属血清肝酶水平与IR及糖代谢相关,尤其GGT是IR的危险因素。

Objective To investigate the correlation between serum liver enzymes levels and fasting blood glucose,insulin resistance（IR） in the first degree relatives of type 2 diabetes mellitus. Methods 142 first degree relatives of type 2 diabetes mellitus ac- cording to the fasting blood glucose （FBG） values were divided into three groups. FBG of A group was less than 6. lmmol/L（79 cases） ; FBG of B group was greater than or equal to 6.1 mmol/L and less than 7.0mmol/L （32 cases） ;FBG of C group was greater than or equal to 7.0mmol/L（ 31 cases）. Blood pressure, FBG, triglyceride （ TG）, total cholesterol （ TC ）, high - density lipoprotein cholesterol （ HDL - C ）, low - density lipoprotein cholesterol （ LDL - C ）, alanine transaminase （ ALT ）, aspartate aminotransferase （ AST）, gamma - glutamyl- transferase （ GGT）, uric acid （ UA ）, blood urea nitrogen （ BUN ）, creatinine （ Cr ）, and fasting insulin （ FINS ） were detected in all subjects, and insulin resistance index （ HOMA - IR） was calculated. Results The levels of ALT and AST in A, B and C group were an increased tendency gradually, but the difference was not statistically significant （ P 〉 0.05 ）. The levels of FBG, HOMA - IR and GGT in B and C group were significantly increased than those in A group（ P 〈 0.05 ） , and the level of FBG in C group was significantly increased than that in B group （P 〈 0. 05 ）. Spearson correlation analysis showed that GGT, ALT and AST were positively correlated with FBG and HOMA - IR（ P 〈 0.05 ）. Multivariate stepwise linear regression analysis showed that insulin resistance index was positively correlated with BMI, GGT and TG. Conclusion Serum liver enzymes levels may be correlated with insulin resistance and glucose metabolism in the first degree relatives of type 2 diabetes mellitus, especially GGT would be an independent risk factor of insulin resistance.