青年学生血清丙氨酸氨基转移酶异常与体质量指数的关联

Association between abnormal serum alanine aminotransferase and body mass index in college students

目的了解青年学生血清丙氨酸氨基转移酶(alanine aminotransferase,ALT)与体质量指数(body mass index,BMI)之间的关系,旨在为青年人肝功能异常的早期防控提供科学依据。方法对2014—2016年北京交通大学每年9月入学共计10 236名16~24岁青年学生测量血清ALT水平及身高、体重,分析不同性别、城乡来源及民族之间BMI及其对ALT异常发生的影响。结果青年学生ALT异常、超重和肥胖的发生率分别为8.30%,13.74%,4.86%,其中男生ALT异常、超重和肥胖的发生率为11.97%,17.57%,6.99%,明显高于女生检测水平(2.42%,7.58%,1.43%)(P值均<0.01);城镇青年学生ALT异常、超重和肥胖的发生率为7.74%,14.57%,5.55%,与乡村学生水平(9.63%,11.78%,3.23%)之间差异有统计学意义(P值均<0.05)。随着BMI的增高,青年学生的ALT异常发生率呈明显上升趋势,男生在体重过低、体重正常、超重及肥胖组中,ALT异常发生率(3.14%,7.81%,22.47%,39.22%)均高于女生(0.82%,2.19%,6.38%,10.71%)(P值均<0.05);城镇青年学生在体重正常、超重及肥胖组中,ALT异常发生率(4.70%,16.84%,33.67%)均低于乡村(7.00%,25.48%,45.45%)(P值均<0.05);民族之间上述差异无统计学意义。结论青年学生BMI与血清ALT异常升高呈明显正相关,不同性别和城乡来源之间有差异。应采取措施控制青年学生BMI增高,对减少ALT异常有着重要意义。

Objective To investigate the relationship between serum alanine aminotransferase（ ALT） and body mass index（ BMI） in young people. Methods Serum ALT level, height and body weight were measured among 10 236 young people aged from16 to 24 years old selected from Beijing Jiaotong University during 2014 to 2016. ALT and BMI was computed and compared between sex, area and ethnicity. Results The prevalence of abnormal ALT, overweight and obesity was 8. 30%, 13. 74% and4. 86%, respectively. In 6 307 males, the prevalence of abnormal ALT, overweight and obesity was 11.97%, 17.57% and 6.99%,which was significantly higher than that of 3 929 females（ 2.42%,7.58% and 1.43%）（ all P〈0.01）. The prevalence of abnormal ALT, overweight and obesity in 7 172 students from urban areas was 7. 74%, 14. 57% and 5. 55%, and the figure was 9. 63%,11. 78% and 3.23% in rural students, with urban students had significantly lower abnormal ALT, but higher overweight and obesity（ P〈0.05）. With the increase of BMI, the prevalence of abnormal ALT increased significantly. Among males with low-than-average-, normal weight, overweight and obesity, the abnormal ALT was 3.14%, 7.81%, 22.47%, 39.22%, respectively, which was higher than that of females（ 0.82%, 2.19%, 6.38%, 10. 71%）（ P〈0. 05）. Among students from urban areas, abnormal ALT in normal weight, overweight and obesity group was 4.70%,16.84% and 33.67%, respectively, which was lower than that in rural area（ 7.00%, 25.48%, 45.45%; P〈0.05）. There was no significant difference in prevalence of abnormal ALT, overweight and obesity among different ethnic groups. Conclusion Significant positive correlation exists between BMI and serum ALT among college students, which shows sex, region difference. It is suggested that reasonable physical exercise, dietary habits and lifestyle could help maintain body weight and reduce the risk of abnormal ALT.