兰州市中老年居民的血清肝酶与2型糖尿病发病的相关性分析

Analysis on the correlation between serum liver enzymes and the incidence of type 2 diabetes mellitus in middle-aged and elderly residents in Lanzhou

目的探讨兰州市中老年居民的丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)和γ-谷氨酰转肽酶(GGT)与2型糖尿病(T2DM)发病的关系。方法于2011年,整群随机抽样兰州市3个社区40~75岁居民5135名,剔除符合排除标准的居民,最终纳入3832名。根据ALT、AST和GGT四分位数分为四组(Q1~Q4组)。非干预性随访≥3年的T2DM发病事件。logistic回归分析血清肝酶与T2DM发病的相关性。绘制受试者操作特征(ROC)曲线分析血清肝酶对T2DM发病的预测价值。结果非干预性随访≥3年,T2DM发病率为6.99%(268/3832)。T2DM组空腹血糖、餐后2 h血糖、糖化血红蛋白、ALT、GGT、甘油三酯和脂肪肝比例均高于非T2DM组,差异有统计学意义(P<0.05);高密度脂蛋白胆固醇低于非T2DM组,差异有统计学意义(P<0.05)。ALT的Q4组T2DM发病率高于ALT的Q1和Q2组,差异有统计学意义(P<0.05);GGT的Q3、Q4组T2DM发病率高于GGT的Q1和Q2组,差异有统计学意义(P<0.05)。logistic回归分析显示,ALT、GGT升高是T2DM发病的独立危险因素(OR>1,P<0.05)。ROC曲线显示,ALT预测T2DM的临界值、曲线下面积、灵敏度和特异度分别为18.5 U/L、0.593、0.519和0.634,GGT分别为20.5 U/L、0.614、0.616和0.572。结论兰州市中老年居民ALT、GGT升高可能与T2DM发病相关。

Objective To investigate the relationship between alanine aminotransferase(ALT),aspartate aminotransferase(AST),andγ-glutamyl transpeptidase(GGT)and type 2 diabetes mellitus(T2DM)in middle-aged and elderly residents in Lanzhou.Methods In 2011,a cluster of 5135 residents aged 40 to 75 years old from three communities in Lanzhou were randomly sampled,and 3832 residents meeting the exclusion criteria were eventually included.They were divided into four groups according to ALT,AST,and GGT quartile(group Q1 to Q4).Non-interventional follow-up≥three years of T2DM events.Logistic regression analysis of the correlation between serum liver enzymes and T2DM.The predictive value of serum liver enzymes for T2DM was analyzed by receiver operating characteristic(ROC)curve.Results Non-interventional follow-up≥three years,the incidence of T2DM was 6.99%(268/3832).The number of fasting blood glucose,2-hour post-meal blood glucose,glycosylated hemoglobin,ALT,GGT,triglyceride,and rate of fatty liver in T2DM group were higher than that in non-T2DM group,and the differences were statistically significant(P<0.05);high density lipoprotein cholesterol(HDL-C)was lower than that in non-T2DM group,and the difference was statistically significant(P<0.05).The incidence of T2DM in ALT group Q4 was higher than that in ALT group Q1 and Q2,and the differences were statistically significant(P<0.05).The incidence of T2DM in GGT group Q3 and Q4 was higher than that in GGT group Q1 and Q2,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that elevated ALT and GGT were independent risk factors for T2DM(OR>1,P<0.05).ROC curve showed that ALT predicted the critical value,area under the curve,sensitivity and specificity of T2DM to be 18.5 U/L,0.593,0.519,and 0.634,while GGT to be 20.5 U/L,0.614,0.616,and 0.572,respectively.Conclusion The elevation of ALT and GGT in middle-aged and elderly residents in Lanzhou may be associated with the onset of T2DM.