2型糖尿病患者血清肝酶谱与甲状腺激素和中国人内脏脂肪指数的关系

Association of serum liver enzymes with thyroid hormones and Chinese visceral adipose index in patients with type 2 diabetes mellitus

目的探讨2型糖尿病患者血清肝酶谱与甲状腺激素和中国人内脏脂肪指数(Chinese visceral adipose index,CVAI)的关系,分析影响肝酶的因素。方法选取700例于本院内分泌科住院的2型糖尿病患者,根据肝酶是否升高分为肝酶升高组和肝酶正常组,再将丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、谷氨酰胺转肽酶(GGT)分别进行三等分分组。比较2组间及ALT、AST、GGT三等分分组间甲状腺激素和CVAI的差异,分析ALT、AST、GGT与甲状腺激素和CVAI的相关性。结果肝酶升高组较肝酶正常组T4、CVAI升高(P<0.05)。随着ALT、AST的升高,FT3、T3、T4逐渐升高(P<0.05);随着ALT、GGT的升高,CVAI也逐渐升高(P<0.05)。相关性分析显示,ALT、AST与FT3、T3、T4呈正相关;ALT、GGT与CVAI呈正相关;CVAI与FT3、T3呈正相关;HbA1C与FT3、T3和T4呈负相关。回归分析显示,FT3、CVAI和HbA1C是ALT的影响因素,T4是AST的影响因素,T3和HbA1C是GGT的影响因素。结论2型糖尿病患者中甲状腺激素和CVAI与肝酶水平均有一定相关性。

Objective To explore the association of serum liver enzymes with thyroid hormones and Chinese visceral adipose index(CVAI)in patients with type 2 diabetes mellitus(T2DM),and to evaluate the influencing factors of liver enzymes.Methods A total of 700 patients with T2DM were divided into elevated liver enzyme group and normal liver enzyme group,or three groups according to tertiles in alanine aminotransferase(ALT),aspartate aminotransferase(AST),and glutamyltransferase(GGT).The differences of thyroid hormones and CVAI among groups were compared,and the correlations of liver enzyme levels with thyroid hormones and CVAI were determined.Results Compared with the normal liver enzyme group,thyroxine(T4)and CVAI were increased in the elevated liver enzyme group(P<0.05).Free triiodothyroid(FT3),triiodothyroid(T3),and T4 levels were elevated with the increase of ALT and AST(P<0.05).CVAI was elevated with the increase of ALT and GGT(P<0.05).Correlation analysis showed that FT3,T3,and T4were positively correlated with ALT and AST.ALT and GGT were positively correlated with CVAI.CVAI was positively correlated with FT3 and T3.HbA1Cwas negatively correlated with FT3,T4,and T3.Regression analysis showed that FT3,CVAI,and HbA1C were the influencing factors for ALT,T4 was the influencing factor for AST,T3 and HbA1Cwere the influencing factors for GGT.Conclusions In patients with T2DM,thyroid hormones and CVAI are correlated with liver enzymes.