The associations of physical activity and adiposity with alanine aminotransferase and gamma-glutamyltransferase

The mechanisms linking obesity and inactivity to diabetes mellitus are unclear. Recent studies have shown associations of alanine aminotransferase (ALT) and gamma-glutamyltransferase (GGT) with diabetes. In a random sample of 3,789 British women aged 60-79 years, the authors examined the associations of obesity and physical activity with ALT and GGT (1999-2001). Both body mass index and waist:hip ratio were independently (of each other, physical activity, alcohol consumption, smoking, and childhood and adulthood social class) positively and linearly associated with ALT and GGT. In adjusted models, a one-standard-deviation increase in body mass index was associated with a 0.46-units/liter (95% confidence interval (CI): 0.16, 0.75) increase in ALT and a 2.14-units/liter (95% CI: 0.99, 3.30) increase in GGT. Similar results for a one-standard-deviation increase in waist:hip ratio were 13.96 (95% CI: 10.44, 17.48) for ALT and 39.44 (95% CI: 25.89, 52.98) for GGT. Frequency of physical activity was inversely and linearly associated with GGT in fully adjusted models, but the inverse association with ALT was attenuated towards the null after adjustment for body mass index and waist:hip ratio. Adjustment for ALT and GGT resulted in some attenuation of the strong linear associations of body mass index and waist:hip ratio with diabetes. These findings provide some support for the suggestion that the relation between obesity and diabetes is, at least in part, mediated by liver pathology.     

The associations between height components (leg and trunk length) and adult levels of liver enzymes

STUDY OBJECTIVE: To examine the separate associations of leg length, a biomarker of prepubertal exposures and growth, and trunk length with adult levels of liver enzymes: alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), aspartate transaminase (AST) and alkaline phosphatase (ALP). METHODS: A cross-sectional analysis of baseline data from the British Women's Health and Heart Study, a random sample of British women aged 60-79 years. RESULTS: Leg length was inversely associated with age-adjusted levels of ALT, GGT and ALP. These associations remained when controlling for childhood and adulthood social class, physical activity, smoking, alcohol consumption, waist-to-hip ratio and trunk length. Trunk length was positively associated with ALT and inversely associated with ALP and the associations remained when adjusting for covariables. CONCLUSIONS: Adult liver function is affected by early life environmental exposures as reflected in leg length, and this may suggest common childhood influences on liver development and adult risk of diabetes and coronary heart disease. Further studies with detailed measures of early life exposures relevant to leg length would be valuable in identifying any specific exposures contributing to adult liver function and cardiovascular disease.     

Combined Associations of Liver Enzymes and Obesity With Diabetes Mellitus Prevalence: The Tohoku Medical Megabank Community-based Cohort Study

BackgroundAlanine aminotransferase (ALT) and gamma-glutamyl transferase (GGT) are enzymes associated with diabetes mellitus (DM) prevalence. However, limited information is available regarding the association of liver enzymes and DM consistently present in obese and non-obese individuals. We examined whether the combination of ALT and GGT enzymes is associated with the prevalence of DM, regardless of obesity, in a general Japanese population.MethodsWe conducted a cross-sectional study of 62,786 participants aged ≥20 years who lived in Miyagi and Iwate, Japan. We divided all the participants into eight groups according to the ALT level (low: <30 IU/L and high: ≥30 IU/L), GGT level (low: <50 IU/L and high: ≥50 IU/L), and the presence of obesity. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) using multivariable logistic regression analysis, adjusting for potential confounders, to determine associations of the combination of ALT and GGT levels and obesity with DM prevalence.ResultsOverall, 6,008 participants (9.6%) had DM. Compared to non-obese individuals with low ALT and GGT levels, the participants with high ALT and GGT levels had high ORs for DM in both obese (OR 4.06; 95% CI, 3.61–4.56) and non-obese groups (OR 2.19; 95% CI, 1.89–2.52). The obese group had high ORs for DM, even at low ALT and GGT levels.ConclusionHigh ALT and GGT levels are associated with DM prevalence in obese and non-obese participants. This finding suggests that correcting ALT and GGT levels and controlling obesity are important for the prevention of DM.Key words: diabetes mellitus, alanine aminotransferase, gamma-glutamyl transferase, obesity, non-obesity     

Association between Physical Activity and Non-Alcoholic Fatty Liver Disease in Adults with Metabolic Syndrome: The FLIPAN Study

Background: A lifestyle with regular PA (physical activity) and Mediterranean diet has benefits on NAFLD (non-alcoholic fatty liver disease) and MetS (metabolic syndrome). Objectives: To assess the association between physical activity and NAFLD in adults with MetS. Design: Cross-sectional study in 155 participants (40–60 years old) from Balearic Islands and Navarra (Spain) with diagnosis of NAFLD and MetS, and BMI (body mass index) between 27 and 40 Kg/m². Methods: PA level was categorized into two groups according to weekly METs (metabolic equivalents of tasks). PA was assessed using a validated Minnesota questionnaire and accelerometers. MetS parameters were assessed by blood collection analysis and NAFLD by abdominal MRI (magnetic resonance imaging). Results: Participants with high PA showed more energy expenditure and expended more calories than ingested (−143.9 Kcal/day; p < 0.001). PA was a risk factor for AST (aspartate aminotransferase) (adjusted OR: 7.26; 95% CI: 1.79–29.40) and a protective factor for ALT (alanine aminotransferase) (adjusted OR: 0.24; 95% CI: 0.12–0.48), GGT (gamma-glutamyl transferase) (adjusted OR: 0.52; 95% CI: 0.29–0.94) and IFC-NMR (intrahepatic fat content by nuclear magnetic resonance) (adjusted OR: 0.26; 95% CI: 0.12–0.56) when sociodemographic confounders were considered. Conclusions: NAFLD patients with high PA showed more positive relationship on MetS parameters and liver profile (ALT, GGT, IFC-NMR) than subjects with low PA, but not for AST. Difference between calories ingested and expended influenced this relationship.     

Serum dioxin and hepatic abnormalities in veterans of Operation Ranch Hand

PURPOSE: We studied hepatic abnormalities and indices of hepatic function in relation to exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (dioxin) in veterans of Operation Ranch Hand, the Air Force unit responsible for the aerial spraying of herbicides in Vietnam from 1962 to 1971. METHODS: The prevalence of ever having liver disease through March 1993, and level of alanine aminotransferase, aspartate aminotransferase, gamma-glutamyltransferase (GGT), lactic dehydrogenase (LDH), alkaline phosphatase, and total bilirubin were examined according to serum dioxin levels. RESULTS: We found an increased risk of "other liver disorders" among veterans with the highest dioxin levels [adjusted odds ratio (OR) = 1.6, 95% confidence interval (CI) 1.2 to 2.1], due primarily to increased transaminases or LDH (adjusted OR = 2.7, 95% CI 1.4 to 5.1) and to other nonspecific liver abnormalities (adjusted OR = 1.4, 95% CI 1.0 to 2.0). CONCLUSIONS: Whether the associations observed were causal is unclear from these data.     

血清谷氨酰转肽酶和丙氨酸氨基转移酶水平与代谢综合征的关系研究

目的 探讨北京地区体检人群谷氨酰转肽酶和丙氨酸氨基转移酶与代谢综合征的关系以及谷氨酰转肽酶和丙氨酸氨基转移酶是否可作为代谢综合征的组成成分.方法 应用北京地区企事业单位人群2008年体检数据分析谷氨酰转肽酶和丙氨酸氨基转移酶与代谢综合征的相关性.代谢综合征诊断标准采用中国糖尿病学会(2004)标准.结果 谷氨酰转肽酶和丙氨酸氨基转移酶高四分位组代谢综合征的检出率明显高于低四分位组.其中,男性谷氨酰转肽酶低四分位代谢综合征检出率为7.57％,高四分位代谢综合征检出率为29.04％;女性谷氨酰转肽酶低四分位代谢综合征检出率为1.28％,高四分位代谢综合征检出率为17.86％;男性丙氨酸氨基转移酶低四分位代谢综合征检出率为9.27％,高四分位代谢综合征检出率为21.88％;女性丙氨酸氨基转移酶低四分位代谢综合征检出率为3.52％,高四分位代谢综合征检出率为14.70％(P ＜0.01).谷氨酰转肽酶诊断代谢综合征适宜的切点值是男性31 U/L,女性18 U/L.丙氨酸氨基转移酶诊断代谢综合征适宜的切点值是男性23 U/L,女性19 U/L.结论 北京地区人群代谢综合征的检出率随着血谷氨酰转肽酶和丙氨酸氨基转移酶水平升高而升高,谷氨酰转肽酶和丙氨酸氨基转移酶水平在正常范围内时也符合这个规律.     

The influence of maternal cigarette smoking, snuff use and passive smoking on pregnancy outcomes: the Birth To Ten Study

This article describes the patterns and effects of maternal snuff use, cigarette smoking and exposure to environmental tobacco smoke during pregnancy on birthweight and gestational age, in women living in Johannesburg and Soweto in 1990. A cohort of 1593 women with singleton live births provided information about their own and household members' usage of tobacco products during pregnancy. The women completed a questionnaire while attending antenatal services. Data on gestational age and birthweight were obtained from birth records. Women who smoked cigarettes or used snuff during pregnancy accounted for 6.1% and 7.5% of the study population respectively. The mean birthweight of non-tobacco users was 3148 g [95% CI 3123, 3173] and that of the smokers 2982 g [95% CI 2875, 3090], resulting in a significantly lower mean birthweight of 165 g for babies of smoking mothers (P = 0.005). In contrast, women using snuff gave birth to infants with a mean birthweight of 3118 g [95% CI 3043, 3192], which is a non-significant (P = 0.52) decrease (29.4 g) in their infants' birthweights compared with those not using tobacco. A linear regression analysis identified short gestational age, female infant, a mother without hypertension during pregnancy, coloured (mixed racial ancestry), and Asian infants compared with black infants, lower parity, less than 12 years of education and smoking cigarettes as significant predictors of low birthweight, while the use of snuff during pregnancy was not associated with low birthweight. The snuff users, however, had a significant shorter gestational age than the other two groups of women. The birthweight reduction adjusted for possible confounders was 137 g [95% CI 26.6, 247.3 (P = 0.015)] for cigarette smokers and 17.1 g [95% CI -69.5, -102.7, P = 0.69] for snuff users respectively, compared with the birthweight of non-tobacco users. Among women who did not smoke cigarettes or use snuff, exposure to environmental tobacco smoke did not result in significant effects on the birthweight of their infants. In conclusion, infants of cigarette smokers had significantly lower birthweights than those of non-tobacco users or snuff users who are exposed to nicotine during pregnancy. Passive smoking did not affect birthweight significantly in this population.     

Socioeconomic disparities in metabolic syndrome differ by gender: evidence from NHANES III

PURPOSE: The aim of the study is to examine whether socioeconomic position (SEP) is associated with metabolic syndrome and whether the association differs by gender and race/ethnicity. METHODS: Study participants were from the Third National Health and Nutrition Examination Survey. SEP was measured by using education and poverty income ratio (PIR). Metabolic syndrome was measured according to the National Institutes of Health guidelines. Multivariable-adjusted logistic regression analyses were performed. RESULTS: Low education (<12 years) was associated with metabolic syndrome in women (odds ratio [OR], 1.77; 95% confidence interval [CI], 1.39-2.24) and less so in men (OR, 1.27; 95% CI, 0.97-1.66) versus more than 12 years of education. For income, low PIR (相似文献   

Modulating influence of cytochrome P-450 MspI polymorphism on serum liver function profiles in coke oven workers

OBJECTIVES: It was reported previously that topside oven workers with heavy exposure to coke oven emissions had increased serum activities of hepatic aminotransferase in one coke oven plant. This study was conducted to investigate the modifying effect of CYP1A1 MspI polymorphism on liver function profiles in coke oven workers. METHODS: 88 coke oven workers from a large steel company in Taiwan were studied in 1995-6. Exposure was categorised by work area: topside oven workers and sideoven workers. Liver function profiles including serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), r-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), and total bilirubin (BIL) were examined in the morning after personal exposure measurements. The MspI polymorphism was determined by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). RESULTS: Five of 23 (22%) topside oven workers and seven of 65 (11%) sideoven workers had the CYP1A1 MspI homozygous variant genotype. With sideoven workers with the combined wild type and heterozygous variant as the reference group in multiple regression models, it was found that topside oven workers with the combined traits had mean AST and ALT activities that were 21% and 46% higher (95% confidence interval (95% CI) 4% to 42% and 12% to 91%, respectively) than the reference group after adjusting for appropriate confounders. Also, topside oven workers with the homozygous variant trait had mean AST, ALT, and GGT activities that were 59%, 68%, and 157% higher (95% CI 21% to 109%, 6% to 168%, and 39% to 374%, respectively) than the reference group. The prevalence of an abnormal hepatocellular pattern (AST > 37 IU/l or ALT > 39 IU/l) was more common in the topside oven workers with the homozygous variant than in the sideoven workers with the other combined genotypes (adjusted odds ratio 9.9, 95% CI 1.2 to 82.3) after adjusting for appropriate confounders. CONCLUSIONS: The CYP1A1 MspI polymorphism may modify the biotransformation of coke oven emissions, which results in hepatocellular damage in coke oven workers.     

Dietary Patterns and Serum Gamma-Glutamyl Transferase in Japanese Men and Women

Background

Although specific foods and nutrients have been examined as potential determinants of serum gamma-glutamyl transferase (GGT) concentrations, the relationship between dietary patterns and GGT remains unknown. The present cross-sectional study aimed to determine relationships between dietary patterns and GGT concentrations, and the effects of lifestyle factors on GGT.

Methods

Relationships between dietary patterns and GGT were analyzed in 9803 Japanese individuals (3723 men and 6080 women age 40–69 years) without a history of liver diseases or elevated serum aminotransferase. We examined major dietary patterns by factor analysis of 46 items determined from a validated, short food frequency questionnaire.

Results

We defined dietary patterns as healthy, Western, seafood, bread, and dessert. The healthy pattern was inversely related to GGT in men (odds ratio [OR] for highest vs lowest quartile, 0.72; 95% confidence interval [CI], 0.57–0.92; P < 0.01 for trend) and women (OR 0.82; 95% CI, 0.66–1.0; P = 0.05 for trend), whereas the seafood pattern was positively related to GGT in men (OR 1.27; 95% CI, 1.01–1.61; P = 0.03 for trend) and women (OR 1.21; 95% CI, 0.98–1.49; P = 0.05 for trend). Male-specific inverse associations with GGT were found for bread and dessert patterns (OR 0.63; 95% CI, 0.50–0.80 and OR 0.53; 95% CI, 0.41–0.68, respectively; P < 0.01 for both trends). Seafood or bread patterns and alcohol consumption significantly interacted with GGT in men (P = 0.03 and <0.01 for interaction, respectively) and between the dessert pattern and body mass index or smoking habit in women (P = 0.03 and <0.01, respectively, for interaction).

Conclusions

Dietary patterns may be important determinants of GGT, and their possible clinical implications warrant further investigation.Key words: dietary pattern, gamma-glutamyl transferase, factor analysis     

Serum liver function profiles in coking workers

Coking workers are regularly exposed to coke oven emissions (COE), which consist mainly of polycyclic aromatic hydrocarbons and volatile organic compounds. In a previous cross-sectional study, we found that coking and by-product workers with heavy exposure to COE in the older of two coke operation areas in Taiwan had higher serum activities of hepatic aminotransferase than the controls. In this study, we further examine the relationship of exposure to COE with liver function profiles in coking workers. Liver function profiles included serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), γ-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), and total bilirubin (BIL). The exposed group included 88 workers working 3 months or more in the older coke oven plant. Fifty-nine referents, not visiting the coke operation areas in the last 3 months, came from the administrative area in the same company. Each participant wore a personal monitor that was used to measure benzene soluble fraction (BSF) of total particulates, as a surrogate of COE, for 3 consecutive days between August 1995 and February 1996. Serum liver function profiles, hepatitis B surface antigens, and anti-hepatitis C antibodies were examined in the morning following the exposure measurements. Exposure levels were categorized by exposure situations (high, medium, low) among coking workers. The high exposure group (n = 23) worked topside of the oven. The medium exposure group (n = 44) worked at the sideoven for more than 4 hr/day, whereas the low exposure group (n = 21) worked at the sideoven for less than 4 hr/day and mostly remained in the control rooms. The low exposure group was used as an internal comparison group. The median BSF concentrations for various exposure situations were as follows, high exposure group: 372 μg/m³, medium exposure group: 61 μg/m³, low exposure group: 49 μg/m³, and referents: 10 μg/m³. The coking workers (n = 88) did not significantly differ from the referents (n = 59) in any of the liver function profiles. Excluding the referents, workers in the high exposure group had a mean AST level that was 31% higher (95% confidence interval (CI) = 9–57%) and a mean ALT level that was 46% higher (95%CI = 7–98%) than those in the low exposure group after adjusting for appropriate confounders in multivariate models. The prevalence of an abnormal hepatocellular pattern (AST > 37 IU/L or ALT > 39 IU/L) was more common in the high exposure group than in the low exposure group (adjusted odds ratio = 4.4; 95% CI = 0.9–22.6). However, these associations were not found in GGT, ALP, or BIL. After controlling for the possible effects of nonoccupational factors on serum activity of AST and ALT, we conclude that increased AST and ALT levels among topside coking workers may be caused by heavy inhalation exposure to COE. Additionally, the adverse hepatic effect seems to be caused by a mixture of hazards, rather than a unique identifiable chemical. Am. J. Ind. Med. 32:478–486, 1997. © 1997 Wiley-Liss, Inc.     

Serum enzyme tests in hepatosplenic schistosomiasis

The serum activities of monoamine oxidase (MAO), gamma-glutamyl transferase (GGT) and glutamic dehydrogenase (GDH) enzymes were measured in 25 patients with Schistosoma mansoni infection (Group I), 26 patients with schistosomal hepatosplenomegaly and ascites (Group II) and 21 normal controls. The activities of these enzymes were compared with those of serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP). The mean levels of MAO, GGT and GDH of Group I were not significantly different from controls. The mean levels of MAO and GGT in Group II, however, were significantly different from corresponding mean levels of Group I and the controls at P less than .001. Changes in the mean level of GDH and ALT were not significant. By contrast, the levels of AST and ALP in both groups showed significant elevation over control levels at P less than .001. These results indicate that estimation of the two enzymes MAO and GGT may aid in the biochemical differentiation of the stages of schistosomiasis and their associated hepatic complications.     

Relation between elevated serum alanine aminotransferase and metabolic syndrome in Korean adolescents

BACKGROUND: Concern is growing about nonalcoholic fatty liver disease, not only because it is a common liver disorder but also because it is one of the leading causes of chronic liver disease. Unexplained elevations in aminotransferase concentrations have been strongly associated with adiposity and thus may represent nonalcoholic fatty liver disease. OBJECTIVE: We investigated the relation between nonviral or nonalcoholic elevations in alanine aminotransferase (ALT) and the metabolic syndrome in Korean adolescents. DESIGN: Data were obtained from 1594 subjects aged 10-19 y from the Korean National Health and Nutrition Examination Survey 1998, a cross-sectional health survey of a nationally representative sample of noninstitutionalized civilian South Koreans. Body mass index, waist circumference, blood pressure, fasting glucose, lipid profiles, and serum ALT were measured. RESULTS: The prevalence of elevated ALT (> 40 U/L) was 3.6% in boys and 2.8% in girls. The prevalence of metabolic syndrome was 3.3% in both boys and girls. The components of the metabolic syndrome were significantly worse in the group with elevated ALT concentrations than in the group with normal ALT concentrations. The odds ratios (95% CIs) for elevated ALT were 6.6 (3.7, 11.8), 2.3 (1.2, 4.6), and 3.0 (1.6, 5.8) in the adolescents with abdominal obesity, high triacylglycerol concentrations, and low HDL-cholesterol concentrations, respectively. The odds ratios for elevated ALT were 1.5 (0.7, 3.1), 2.6 (1.1, 6.2), and 6.2 (2.3, 16.8) in the adolescents with 1, 2, and > or = 3 risk factors (metabolic syndrome), respectively. CONCLUSION: The metabolic syndrome was strongly associated with elevated ALT concentrations in Korean adolescents, and this association existed in a graded fashion across the number of metabolic components.     

肝脏酶谱诊断肝病在临床的应用

目的 探讨肝脏酶谱在诊断肝病中的应用价值.方法 对270例不同肝病患者进行血清肝脏酶谱酶活性的鉴定,并将其与108例非肝病患者的肝脏酶谱进行分析,观察不同肝病患者的肝脏酶谱与非肝病患者有无明显区别.结果 肝病患者的血清肝脏酶谱均出现增高,不同疾病的肝脏酶谱增高幅度不同,与非肝脏疾病的患者相比,差异无统计学意义,其中,急性肝炎的天门冬氨酸氨基转移酶( AST)为(356.28±162.54) U/L,肝硬化碱性磷酸酶(ALP)和谷酰转肽酶(GGT)分别为(87.38±90.46)U/L和(109.21±73.64)U/L,肝癌的ALP和GGT分别为(110.24±109.41)U/L和(138.44±46.26)U/L,乙醇性肝炎GGT、丙氨酸氨基转移酶(ALT)和AST分别为(157.35±68.38)U/L、(89.34±59.52) U/L和(78.66±61.64)U/L,其他肝病的ALP及GGT和ALP与非肝病患者相比,差异有统计学意义.结论 肝脏酶谱在肝病的临床诊断和治疗中有很大的临床应用价值.     

Tissue-specific contaminant accumulation and associated effects on hepatic serum analytes and cytochrome P450 enzyme activities in hooded seals (Cystophora cristata) from the Gulf of St. Lawrence

The current study aims to assess contaminant levels and tissue burdens in hooded seal (Cystophora cristata) blubber, liver, and blood in association with cytochrome P450 (CYP) enzymes (CYP1A and -3A) and serum analytes (hepatic enzymes like alanine aminotransferase [ALT], aspartate aminotransferase, alkaline phosphatase [AP], and γ-glutamyltransferase [GGT], serum proteins, and creatine kinase). Contaminant accumulation levels and patterns of polychlorinated biphenyls, chlorinated pesticides, and polybrominated diphenyl ethers (PBDEs) differed between tissues and seal groups, with the highest levels in liver. Pups showed higher liver contaminant levels, especially for PBDEs, than adults. These high levels might be associated with the ingestion of large amounts of contaminated milk and subsequent accumulation in the liver. Adult males and females mainly differed in PBDE levels, which were higher in females, possibly due to a sex-specific diet. The association between blubber contaminant burdens and the diagnostic enzymes ALT, GGT, and AP, and serum albumin, was inconclusive. In contrast, several CYP isoenzymes showed a clear positive relationship with the overall blubber contaminant burden, indicating enzyme induction following exposure to polyhalogenated hydrocarbons. Therefore, liver CYP isoenzymes may serve as a sensitive biomarker for long-term exposure to polyhalogenated hydrocarbons.     

某焦化厂职业接触多环芳烃焦炉工肝脏某些酶活性的变化

目的探讨多环芳烃(PAHs)对炼焦作业工人某些肝血清酶活性改变的可能影响。方法对乙肝表面抗原(HBsAg)阴性的炼焦作业工人和非PAHs职业接触工人进行总PAHs累积接触指数(CEL-PAHs)评估,尿中1-羟基芘(1-OHP)浓度等级划分,和血清中丙氨酸转移酶(ALT)、天门冬氨酸转移酶(AST)、γ-谷氨酰转移梅(GGT)、碱性磷酸酶(ALP)的检测。结果焦炉工职业性PAHs暴露水平明显高于对照组(P<0·05)。与对照组相比,血清ALT的明显升高可见于CEL-PAHs<50μg/(m3·a)组和尿中1-OHP浓度<2·3μmol/mol肌酐CEL-PAHs≥200μg/m3组,血清AST的明显升高可见于CEL-PAHs<50μg/(m3·a)组;当CEL-PAHs(200μg/(m3·a)或尿中1-OHP浓度≥10·0μmol/mol肌酐时,可发现四种肝生化指标实测值的明显升高(P<0·05),以及ALT、AST和GGT异常率的明显升高(P<0·05),以血清GGT水平的升高(10倍CEL-PAHs的上升导致1·24倍血清GGT水平的升高,10倍尿中1-OHP浓度的上升导致1·19倍的升高)和异常率的上升(logistic回归,调整OR值为6·2~7·2,P<0·05)最为明显。结论PAHs职业暴露可导致炼焦作业工人肝脏某些血清酶活性的升高。     

丙氨酸转氨酶升高患者代谢异常情况及危险因素分析

目的 分析丙氨酸转氨酶（ALT）升高的检出率、伴有代谢异常情况及其危险因素.方法 将12789例体检者（排除乙肝病毒感染、过量饮酒者）进行体格检查、血压、血糖、血脂、肝功、血红蛋白、尿酸、血乙肝表面抗原检测及肝脏超声检查,根据ALT升高与否（〉40 U/L）分为两组,比较两组间各代谢组分的差异.结果 ALT升高的检出率为8.69%.ALT升高组的腰围、体质指数、收缩压、舒张压、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、尿酸、空腹血糖、血红蛋白、总胆红素、谷氨酰转移酶、碱性磷酸酶水平均高于ALT正常组,而年龄、高密度脂蛋白胆固醇（HDL-C）水平低于ALT正常组（P〈0.05）.ALT升高组超重、肥胖、各型高脂血症、空腹血糖受损、糖尿病、舒张压高、高尿酸血症、脂肪肝检出率高于ALT正常组（P〈0.05）.logistic回归分析显示：患脂肪肝、舒张压、体质指数、总胆固醇、血红蛋白是ALT升高的危险因素,年龄、HDL-C是保护因素.结论 非酒精性脂肪性肝病、脂代谢紊乱、肥胖是丙氨酸转氨酶升高的重要危险因素.     

Multiple health behaviors and serum hepatic enzymes among US adults with obesity

IntroductionThis study was to examine the cumulative number and clustering patterns of low-risk health behaviors (i.e., not currently smoking, not excessive drinking, and physically active) associated with elevation of serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyltransferase (GGT) among adults with obesity in the United States.MethodsWe estimated the age-adjusted prevalence of elevated ALT, AST, and GGT from 4547 adults with obesity aged ≥ 20 years who participated in the 2005–2008 National Health and Nutrition Examination Survey. The associations between the cumulative number or clustering patterns of low-risk health behaviors and measures of serum ALT, AST, and GGT were assessed using multivariate regression models.ResultsAdult men who reported having three low-risk health behaviors were 62%, 39%, and 48% less likely to have elevated serum ALT, AST, and GGT, respectively; adult women were 56% and 73% less likely to have elevated serum AST and GGT, respectively, when compared to their respective counterparts who reported having none of the low-risk health behaviors.ConclusionsThe findings of this study indicate that, among adults with obesity, having multiple low-risk health behaviors is associated with decreased likelihoods of elevated hepatic enzymes, including ALT in men, AST and GGT in both men and women.     

Serum perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS) concentrations and liver function biomarkers in a population with elevated PFOA exposure

Background: Perfluorooctanoate (PFOA) and perfluorooctane sulfonate (PFOS) persist in the environment and are found in relatively high concentrations in animal livers. Studies in humans have reported inconsistent associations between PFOA and liver enzymes.Objectives: We examined the cross-sectional association between serum PFOA and PFOS concentrations with markers of liver function in adults.Methods: The C8 Health Project collected data on 69,030 persons; of these, a total of 47,092 adults were included in the present analysis. Linear regression models were fitted for natural log (ln)-transformed values of alanine transaminase (ALT), γ-glutamyltransferase (GGT), and direct bilirubin on PFOA, PFOS, and potential confounders. Logistic regression models were fitted comparing deciles of PFOA or PFOS in relation to high biomarker levels. A multilevel analysis comparing the evidence for association of PFOA with liver function at the individual level within water districts to that at the population level between water districts was also performed.Results: ln-PFOA and ln-PFOS were associated with ln-ALT in linear regression models [PFOA: coefficient, 0.022; 95% confidence interval (CI): 0.018, 0.025; PFOS: coefficient, 0.020; 95% CI: 0.014, 0.026] and with raised ALT in logistic regression models [with a steady increase in the odds ratio (OR) estimates across deciles of PFOA and PFOS; PFOA: OR = 1.10; 95% CI: 1.07, 1.13; PFOS: OR = 1.13; 95% CI: 1.07, 1.18]. There was less consistent evidence of an association of PFOA and GGT or bilirubin. The relationship with bilirubin appears to rise at low levels of PFOA and to fall again at higher levels.Conclusions: These results show a positive association between PFOA and PFOS concentrations and serum ALT level, a marker of hepatocellular damage.     

Betel-quid use is associated with the risk of the metabolic syndrome in adults

BACKGROUND: Betel-quid use has been associated with obesity and hyperglycemia in previous studies. OBJECTIVE: The aim was to test whether betel-quid use contributes to the metabolic syndrome, as defined by the National Cholesterol Education Program Adult Treatment Panel III. DESIGN: Associations between betel-quid use and the metabolic syndrome, obesity, hypertriacylglycerolemia, low HDL cholesterol, hyperglycemia, and high blood pressure after adjustment for sex, age, smoking, alcohol drinking, physical activity, and dietary intakes were studied in nonpregnant adults aged 20-64 y (n = 1986) from the Nutrition and Health Survey in Taiwan (1993-1996). RESULTS: The prevalence of the metabolic syndrome was not significantly different between the men and women (10.1% compared with 9.7%), whereas the prevalence of betel-quid use was higher in the men than in the women (31% compared with 2.3%; P < 0.001). The daily rate of betel-quid use was associated with the metabolic syndrome [odds ratio (OR) associated with a betel-quid consumption rate of 10 times/d: 1.31; 95% CI: 1.12, 1.55; P = 0.003], abdominal obesity (OR: 1.42; 95% CI: 1.2, 1.7; P = 0.001), hypertriacylglycerolemia (OR: 1.33; 95% CI: 1.02, 1.73; P = 0.037), and high blood pressure (OR: 1.2; 95% CI: 1.01, 1.4; P = 0.04). However, the daily rate of betel-quid use was not associated with low HDL cholesterol or hyperglycemia. CONCLUSION: The daily rate of betel-quid use is independently and positively associated with the metabolic syndrome in adults.