65岁以上老年人正常范围内的血清γ-谷氨酰转肽酶与代谢综合征的相关性和剂量-反应关系

Correlation and dose-response relationship between serum γ-glutamyl transferase within the normal range and metabolic syndrome among the elderly aged 65 years and more

目的 探讨65岁以上老年人正常范围内血清γ-谷氨酰转肽酶(γ-glutamyltransferase, GGT)与代谢综合征的相关性和剂量-反应关系。方法 选取2019年武进区65岁以上老年健康体检人群进行问卷调查、体格检查和实验室检查,排除关键变量缺失者、严重肝病患者和GGT异常者,共82 833人纳入研究。采用logistic回归和限制性立方样条图分析血清GGT与代谢综合征患病的相关性和剂量-反应关系。结果 82 833人中代谢综合征患者26 546人,占32.05%。随着血清GGT水平的增加,代谢综合征及其各组分的患病率均逐渐增加(P值均<0.01)。男女均按照GGT水平四分位数进行分组,在调整了相关混杂因素后,与GGT Q1组相比,男性Q2、Q3和Q4组患代谢综合征的OR(95%CI)分别为1.77(1.63~1.91)、2.79(2.59~3.01)和4.04(3.75~4.35);女性Q2、Q3和Q4组患代谢综合征的OR(95%CI)分别为1.85(1.74~1.97)、2.98(2.81~3.16)和4.64(4.37~4.92)。根据GGT百分位数分布,选取4个节点(P_(5),P_(35),P_(65),P_(95)),以第一个节点(P5)为参照组,限制性立方样条图分析结果显示,调整了相关混杂因素后,男、女性血清GGT水平与代谢综合征呈现非线性剂量-反应关系(非线性检验P值均<0.01)。结论 65岁以上老年人正常范围内血清GGT水平与代谢综合征相关,且呈现非线性剂量-反应关系。

Objective To investigate the correlation and dose-response relationship between serum γ-glutamyl transferase(GGT) within the normal range and metabolic syndrome among the elderly aged 65 years and more. Methods The elderly at aged ≥65 years receiving physical examinations in Wujin District in 2019 were recruited to conduct questionnaire survey, physical examination and laboratory tests. After exclusion of individuals with missing key variables, severe liver disorders and abnormal GGT,a total of 82 833 subjects were enrolled in this study. The correlation and dose-response relationship between serum GGT and metabolic syndrome were examined with logistic regression analysis and restricted cubic spline analysis. Results The prevalence of metabolic syndrome was 32.05% among 82 833 participants, and the prevalence of metabolic syndrome and each component of metabolic syndrome increased with serum GGT level(all P<0.01). All participants were grouped according to the GGT quartile. After adjustment for confounding factors, men and women with the Q2 [men: OR=1.77,95%CI:(1.63,1.91);women: OR=1.85,95%CI:(1.74,1.97)],Q3 [men: OR=2.79,95%CI:(2.59,3.01);women: OR=2.98,95%CI:(2.81,3.16)] and Q4 [men: OR=4.04,95%CI:(3.75,4.35);women: OR=4.64,95%CI:(4.37,4.92)]were more likely to develop metabolic syndrome relative to those with the Q1. According to the GGT percentile, four percentiles(P_(5),P_(35),P_(65) and P_(95)) were selected, with P5as the reference. After adjustment for confounding factors, dose-response analysis with restricted cubic splines showed a non-linear dose-response relationship between serum GGT level and metabolic syndrome among men and women(all P<0.01). Conclusion Serum GGT correlates and shows a non-linear dose-response relationship with metabolic syndrome among the elderly aged≥65 years.