| 高血糖与高尿酸血症对丙氨酸氨基转移酶异常的交互作用 |
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| 引用本文： | 翟文海,李雪梅,汪鋆植,林文源.高血糖与高尿酸血症对丙氨酸氨基转移酶异常的交互作用[J].中华疾病控制杂志,2019,23(11):1370-1374. |
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| 作者姓名： | 翟文海 李雪梅 汪鋆植 林文源 |
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| 作者单位： | 三峡大学医学院,宜昌,443003;宜昌市第二人民医院,宜昌,443002 |
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| 基金项目： | 湖北省科技厅重大专项2016ABA107 |
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| 摘 要： | 目的 研究高血糖与高尿酸血症的交互作用对丙氨酸氨基转移酶（alanine aminotransferase，ALT）异常的影响。 方法 选取湖北宜昌地区2018年3-11月健康体检人群5 223名资料完整者进行研究，比较分析508例ALT异常组和513例正常组人群的代谢特征。应用Logistic回归模型研究危险因素的独立效应，应用相加模型、相乘模型对危险因素间的交互作用进行分析。 结果 ALT异常组的尿酸、甘油三脂、总胆固醇、低密度脂蛋白胆固醇、空腹血糖、收缩压、舒张压、体重指数、天冬氨酸氨基转移酶水平均高于对照组，差异有统计学意义（均有P < 0.05）。控制混杂因素后，多因素Logistic回归分析模型结果显示，高血糖及高尿酸血症并存时的ALT异常风险为血糖及尿酸正常者的5.62倍（95% CI:1.65~19.73，P=0.004）。ALT异常危险因素的交互作用分析显示，高血糖及高尿酸之间不存在相乘交互作用，但具有相加交互作用，交互作用指数、相对超危险度比、归因比、纯因子归因交互效应百分比分别为3.02、3.09、54.98%、66.87%。 结论 ALT异常患者同时存在多种代谢指标异常，高血糖及高尿酸血症的正交互作用是其重要危险因素之一，两者共存可增加患病风险。
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| 关 键 词： | 高尿酸血症 高血糖症 丙氨酸氨基转移酶 交互作用 |
| 收稿时间： | 2019-06-23 |
Interactive effect of Hyperglycemia and Hyperuricemia on abnormal alanine aminotransferase |
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| Affiliation: | 1.The Medical College of China Three Gorges University, Yichang 443003, China2.The Second People's Hospital Of Yichang, Yichang 443002, China |
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| Abstract: | Objective To investigate interaction effect of hyperglycemia and hyperuricemia on the patients with abnormal alanine aminotransferase(ALT). Methods From March to November 2018, 5 223 cases with complete and suitable data were enrolled in the physical medical examination in Yichang, Hubei Province of China. The metabolic characteristics of the two groups (508 ALT anomaly cases and 513 normal cases) were compared and analysed, Logistic regression model was used to study the independent effects of risk factors, and the interaction between risk factors was analyzed by additive model and multiplicative model. Results Levels of uric acid, triglyceride, total cholesterol, low density lipoprotein-cholesterol, fasting blood glucose, systolic blood pressure, diastolic blood pressure, body mass index, aspartate aminotransferase were significantly higher than that of the control group(all P < 0.05). After adjusting some confounding factors, multivariate Logistic regression analysis showed that risk of abnormal ALT was 5.62 times higher in subjects with hyperglycemia and hyperuricemia than in subjects without them(95% CI: 1.65-19.73, P=0.004). Interaction analysis of risk factors for abnormal ALT showed that there was no multiplicative interaction between hyperglycemia and hyperuricemia, but with additive interaction, the synergy index was 3.02, the relative excess risk due to interaction was 3.09, the attributable proportion due to interaction was 54.98% and pure factor attribution interaction was 66.87%. Conclusions There are several abnormal metabolic indices in individuals with abnormal ALT. The positive interaction between hyperglycemia and hyperuricemia are among the important risk factors for abnormal ALT patients. They can significantly increase the risk of illness. |
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