Serum gamma-glutamyltransferase and risk of metabolic syndrome and type 2 diabetes in middle-aged Japanese men

OBJECTIVE: To investigate the association between serum gamma-glutamyltransferase (GGT) and risk of metabolic syndrome and type 2 diabetes in Japanese male office workers. RESEARCH DESIGN AND METHODS: This study included 2,957 metabolic syndrome-free men and 3,260 nondiabetic men aged 35-59 years who did not have medication for hepatitis, alanine aminotransferase (ALT) levels higher than three times the upper limit of the reference range, or a history of cardiovascular disease at study entry. Subjects were reexamined at periodic annual health examinations over a 7-year period. We used a modified National Cholesterol Education Program definition of metabolic syndrome with BMI instead of waist circumference and the revised criteria of the American Diabetes Association for type 2 diabetes. RESULTS: With adjustment for age, family history of diabetes, BMI, alcohol intake, cigarette smoking, regular physical activity (fasting plasma glucose for the risk of type 2 diabetes), and white blood cell (WBC) count, the risk of metabolic syndrome and type 2 diabetes increased in correlation with the levels of serum GGT, ALT, aspartate aminotransferase (AST), and alkaline phosphatase. Additional adjustment for all of the other liver enzymes attenuated these associations, but serum GGT remained a significant risk factor for the risk of both metabolic syndrome and type 2 diabetes (P for trend <0.001 for both). Top one-fifth versus bottom one-fifth relative risks of metabolic syndrome and type 2 diabetes were 2.23 (95% CI 1.51-3.30) and 2.44 (1.34-4.46), respectively. CONCLUSIONS: These results indicate that serum GGT may be an important predictor for developing metabolic syndrome and type 2 diabetes in middle-aged Japanese men.     

Hepatic enzymes, the metabolic syndrome, and the risk of type 2 diabetes in older men

OBJECTIVE: We have examined the relationship between hepatic enzymes, the metabolic syndrome, insulin resistance, and type 2 diabetes and assessed the potential of hepatic enzyme measurements in determining diabetes risk. RESEARCH DESIGN AND METHODS: We conducted a prospective study of 3,500 nondiabetic men aged 60-79 years who were followed-up for a mean period of 5 years and in whom there were 100 incident type 2 diabetes cases. RESULTS: In cross-sectional analyses, alanine aminotransferase (ALT) and gamma-glutamyltransferase (GGT) were strongly associated with obesity, insulin resistance, and the metabolic syndrome. Prospectively, the risk of type 2 diabetes significantly increased with increasing levels of ALT and GGT even after adjustment for confounders including BMI (top versus bottom quarter ALT: relative risk 2.72 [95% CI 1.47-5.02]; GGT: 3.68 [1.68-8.04]). Additional adjustment for insulin resistance attenuated the effects, but the relationships with ALT and GGT remained significant (1.91 [1.01-3.60] and 2.69 [1.21-5.97], respectively). Further adjustment for inflammatory markers (C-reactive protein) made minor differences. Among high-risk subjects (obese men or those with the metabolic syndrome), elevated GGT and ALT enhanced the prediction of diabetes risk. CONCLUSIONS: Elevated levels of ALT and GGT within the normal range are independent predictors of type 2 diabetes in older men and are useful additional measures in identifying those at high risk of diabetes.     

血清γ谷氨酰转肽酶与BMI的相关性研究

目的：探讨血清γ-谷氨酰转肽酶（GGT）与BMI水平的关系。方法采用横断面研究法对某轻体力劳动单位职工进行问卷调查、体格检查、生化检测等,对资料完整的172名职工的数据进行分析,比较不同BMI水平、不同性别及不同GGT水平组别间一般资料的差异,采用单因素方差分析、Pearson相关分析及多元逐步回归分析探讨GGT与BMI的相关性。结果体质量过低组、正常体质量组、超体质量组、肥胖组4组间GGT水平比较差异有统计学意义（P＜0.05）;男性4个GGT四分位组间BMI、腹围、心率、舒张压、ALT、AST、碱性磷酸酶（ALP）比较差异有统计学意义（P＜0.05）;女性4个GGT四分位组间ALT、AST、ALP、HDL-C、甘油三酯比较差异有统计学意义（P＜0.05）;Pearson 相关分析显示,男性组 GGT 水平与 BMI、腹围、心率、肝右斜径、ALT、AST、ALP呈正相关,女性组GGT水平与BMI、腹围、收缩压、舒张压、ALT、AST、ALP、血肌酐、甘油三酯呈正相关,与HDL-C呈负相关。多元逐步回归分析提示GGT可以显著影响BMI及腹围;调整了性别、年龄、GGT、肝右斜径、ALT、AST、ALP、血肌酐、HDL-C、LDL-C、甘油三酯、空腹血糖等指标之后,GGT与BMI独立相关。结论血清GGT水平的上升与BMI水平存在显著且独立的相关性。     

Vapor condensate of exhaled air in evaluating the impaired metabolism of the bronchopulmanory system in nonspecific lung diseases

The degree of metabolic rehabilitation of the bronchopulmonary system was evaluated in non-specific pulmonary diseases, like pneumonia or chronic obstructive bronchitis, by using the data of biochemical testing of the exhaled-air vapor condensate. Nine parameters were investigated, i.e. enzymes alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase, alkaline phosphatase (AP), gamma-glutamate amino-transpeptidase (GGT) as well as parameters of protein metabolism--common protein, seromucoid (SC), C-reactive protein and urea. AST, ALT, AP, GGT, SC and urea were acknowledged as the most informative parameters. The results are indicative of that the recovery of metabolic processes in the bronchopulmonary system was not completed.     

Pregravid Liver Enzyme Levels and Risk of Gestational Diabetes Mellitus During a Subsequent Pregnancy

OBJECTIVE

Liver enzymes are independent predictors of type 2 diabetes. Although liver fat content correlates with features of insulin resistance, a risk factor for developing gestational diabetes mellitus (GDM), the relationship between liver enzymes and GDM is unclear. The objective of this study was to assess whether pregravid liver enzyme levels are associated with subsequent risk of GDM.

RESEARCH DESIGN AND METHODS

A nested case-control study was conducted among women who participated in the Kaiser Permanente Northern California multiphasic health checkup (1984–1996) and had a subsequent pregnancy (1984–2009). Case patients were 256 women who developed GDM. Two control subjects were selected for each case patient and matched for year of blood draw, age at examination, age at pregnancy, and number of intervening pregnancies.

RESULTS

Being in the highest quartile versus the lowest quartile of γ-glutamyl transferase (GGT) levels was associated with a twofold increased risk of subsequent GDM (odds ratio 1.97 [95% CI 1.14–3.42]), after adjusting for race/ethnicity, prepregnancy BMI, family history of diabetes, and alcohol use. This result was attenuated after adjusting for homeostasis model assessment of insulin resistance (HOMA-IR), fasting status, and rate of gestational weight gain. There was significant interaction between GGT and HOMA-IR; the association with GGT was found among women in the highest tertile of HOMA-IR. Aspartate aminotransferase and alanine aminotransferase were not associated with increased GDM risk.

CONCLUSIONS

Pregravid GGT level, but not alanine aminotransferase or aspartate aminotransferase level, predicted the subsequent risk of GDM. Markers of liver fat accumulation, such as GGT level, are present years before pregnancy and may help to identify women at increased risk for subsequent GDM.     

Features of the metabolic syndrome predict higher risk of diabetes and impaired glucose tolerance: a prospective study in Mauritius

OBJECTIVE: To assess the independent and joint effects of the components of the metabolic syndrome, including leptin, which is a recently proposed addition to this syndrome, in predicting the cumulative incidence of impaired glucose tolerance (IGT) and diabetes among individuals with normal glucose tolerance. RESEARCH DESIGN AND METHODS: This prospective study involved 2,605 residents of Mauritius with normal glucose tolerance who were followed for 5 years for IGT or diabetes onset in relation to total and regional adiposity (BMI, waist-to-hip ratio [WHR]), fasting and 2-h 75-g oral glucose load glucose and insulin, total and HDL cholesterol, blood pressure, serum uric acid, triglyceride, and leptin levels. RESULTS: A multivariate logistic regression model adjusted for age, sex, ethnicity, and diabetes family history showed a significantly higher linear increase in risk of IGT and diabetes in association with the following variables only: fasting glucose (odds ratio 1.89 [95% CI 1.51-2.34]), 2-h glucose (1.68 [1.50-1.88]), WHR (1.30 [1.10-1.52]), BMI (1.04 [1.00-1.08]), and serum uric acid (1.37 [1.20-1.57]). However, a nonlinear increase was seen with serum triglyceride and plasma leptin concentrations. No risk factors resulted in joint effects that were greater than expected from combining individual effects. CONCLUSIONS: Metabolic syndrome features independently predict a higher risk of diabetes or IGT in normoglycemic subjects but in combination confer no higher-than-expected risk of these outcomes. At higher concentrations of triglycerides and leptin, risk plateaus and even declines slightly.     

Comparative analysis of enzyme activity in human colostrum, milk, and serum

Changes of enzyme activity in the colostrum, milk, and serum samples of 14 mothers were followed. For the enzyme assay, the colostrum and the milk samples were diluted, 1:10 and 1:5, respectively. The activity of the following enzymes were measured: lactate dehydrogenase (LDH); gammaglutamyl transpeptidase (GGT); aspartate aminotransferase (ASAT); alanine aminotransferase (ALAT); cholinesterase; alkaline, and acid phosphatase. Milk, LDH, ASAT, and ALAT activities did not change during the first four days of lactation, yet were significantly higher than the corresponding activities of serum. The activity of GGT and alkaline and acid phosphatase in milk showed a marked decrease by day 4 postpartum; however, the GGT stayed much higher than that of serum, while the activity of the other two enzymes decreased to the level of the serum. By contrast, as compared to the colostrum, the cholinesterase activity in the breast milk showed a significant increase.     

煤矿职业健康检查人群血清-谷氨酰转肽酶与血压、血脂、血糖相关性分析

目的 探讨肝功能指标血清-谷氨酰转肽酶（GGT）与代谢综合征（MS）的相关性。方法 选取邯郸地区2372名煤矿工人为研究对象,按血清GGT水平四分位数分为四组,以SPSS 17.0统计软件分析其血清GGT与收缩压（SBP）、舒张压（DBP）、空腹血糖（FPG）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、体重指数（BMI）之间的相关性。结果 血清GGT与年龄、SBP、DBP、TC、TG、HDL-C、FPG、BMI比较差异均有统计学意义（P0.001）,最低四分位组到最高四分位组,随着血清GGT水平的上升,SBP、DBP、TC、TG、FPG、BMI各指标水平升高,HDL-C水平降低。通过Pearson分析,研究对象的GGT水平与年龄、TG、TC、FPG、SBP、DBP、BMI等均呈显著正相关（r值分别为0.110、0.313、0.352、0.163、0.174、0.141、0.212）,与HDL-C呈负相关（P0.01）。多因素逐步回归分析后显示, TG、TC、FPG、SBP、血红蛋白（HGB）指标为该人群血清GGT危险因子（值分别为0.215、0.274、0.100、0.098、0.077）。结论 煤矿在岗工人血清GGT水平同MS组分血压、血脂、血糖呈显著相关,可为该人群MS的早期诊断提供一定的参考。     

Alanine aminotransferase and gamma-glutamyl transferase are associated with the metabolic syndrome but not with angiographically determined coronary atherosclerosis

BACKGROUND: Recently, elevated liver enzymes have attracted great interest as potential novel markers of cardiovascular risk. Their association with angiographically determined coronary artery disease (CAD) is unknown. METHODS: We enrolled 1000 consecutive patients undergoing coronary angiography for the evaluation of suspected or established stable CAD. The metabolic syndrome (MetS) was defined according to ATP-III criteria; significant CAD was diagnosed in the presence of coronary stenoses with lumen narrowing >/=50%. RESULTS: Serum alanine aminotransferase (ALT), the ALT/aspartate aminotransferase (AST) ratio, and serum gamma-glutamyl transferase (GGT) were significantly higher in patients with the MetS than in subjects without the MetS (34+/-21 vs. 29+/-20 U/l; p<0.001, 1.16+/-0.39 vs. 1.00+/-0.36 U/l, p<0.001; and 53+/-88 vs. 43+/-57 U/l, p=0.001, respectively) but were similar in patients with significant CAD as in those who did not have significant CAD at angiography (p=0.592; p=0.731, and p=0.716, respectively). Analysis of covariance after multivariate adjustment including alcohol consumption confirmed that ALT, ALT/AST ratio, and GGT were significantly and independently associated with the MetS but not with significant CAD. CONCLUSIONS: ALT, the ALT/AST ratio, and GGT are associated with the MetS but not with angiographically determined coronary atherosclerosis.     

Liver alanine aminotransferase, insulin resistance and endothelial dysfunction in normotriglyceridaemic subjects with type 2 diabetes mellitus

BACKGROUND: Plasma levels of liver transaminases, including alanine aminotransferase (ALT), are elevated in most cases of nonalcoholic fatty liver disease (NAFLD). Elevated ALT levels are associated with insulin resistance, and subjects with NAFLD have features of the metabolic syndrome that confer high-risk cardiovascular disease. Alanine aminotransferase predicts the development of type 2 diabetes (DM2) in subjects with the metabolic syndrome. However, the role of elevated ALT levels in subjects with overt DM2 has yet not been explored. MATERIALS AND METHODS: In a cross-sectional study, 64 normotriglyceridaemic subjects with DM2 were studied with regard to the relation between liver transaminases with whole-body insulin sensitivity, measured with the euglycaemic hyperinsulinaemic clamp and with brachial artery flow-mediated dilation (FMD) as a marker of endothelial dysfunction. RESULTS: On average, patients were normotriglyceridaemic (plasma triglycerides 1.3 +/- 0.4 mmol L-1) and had good glycaemic control (HbA1c 6.2 +/- 0.8%). The mean ALT level was 15.0 +/- 7.5 U L-1, and the mean aspartate aminotransferase concentration equalled 10.6 +/- 2.6 U L-1. Alanine aminotransferase levels were negatively associated with whole-body insulin sensitivity as well as with FMD (both P = 0.03, in multivariate analyses; regression coefficients beta [95%CI]: -0.76 [-1.4 to -0.08] and -0.31 [-0.58 to -0.03] respectively). CONCLUSIONS: In metabolically well-controlled patients with DM2, ALT levels are related to decreased insulin-sensitivity and an impaired conduit vessel vascular function.     

Parental history of type 2 diabetes and cardiometabolic biomarkers in offspring

Eur J Clin Invest 2012; 42 (9): 974-982 ABSTRACT: Background Parental history of type 2 diabetes (T2D) is associated with cardiometabolic risk. We aimed to investigate the associations of parental history of T2D with cardiometabolic biomarkers and to subsequently investigate to what extent these putative associations were explained by modifiable factors. Materials and methods Cross-sectionally, we analysed a random sample of 2001 participants without T2D (20-70?years) from the European Prospective Investigation into Cancer and Nutrition-Netherlands (EPIC-NL). Plasma levels of 12 biomarkers - total, HDL and LDL-cholesterol, triglycerides, HbA1c, gamma-glutamyltransferase (GGT), alanine aminotransferase (ALT), asparate aminotransferase (AST), albumin, uric acid, creatinine and high-sensitivity CRP (hs-CRP) - were assessed according to categories of parental history of T2D. Results In age and sex-adjusted analyses, offspring with parental history of T2D had significantly higher ALT [β?=?0·074; 95% confidence interval (95%CI), 0·023-0·126] and AST levels (β?=?0·033; 95%CI, 0·001 to 0·066) and a trend towards higher HbA1c (β?=?0·011; 95%CI, -0·001 to 0·024) and GGT (β?=?0·049; 95%CI, -0·015 to 0·112) levels. Adjustment for diet, smoking, alcohol intake, physical activity and educational level modestly attenuated the magnitude of these associations, but they remained significant for ALT and borderline significant for AST. After further adjustment for adiposity, additional attenuation was observed, but the association remained significant for ALT. Only maternal history of T2D was associated with higher ALT levels. T2D in both parents was associated with increased levels of all liver enzymes, but the association remained significant for GGT after adjustment for adiposity. Overall, the modifiable factors explained 21·2-45·4% of these associations. The contribution of adiposity was 18·2-38·9%. Conclusion We conclude that parental history of T2D was associated with higher non-fasting levels of liver enzymes in a general population without T2D. Adiposity substantially contributed to these associations. The contribution of diet and lifestyle factors was modest.     

肝损伤酶活性联合检测在肝胆疾病诊断中的相关分析

目的探讨肝损伤酶活性联合检测在肝胆疾病诊断中的临床意义。方法对健康对照组36例和各类肝胆疾病组204例患者的丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、乳酸脱氢酶、腺苷脱氨酶、线粒体天门冬氨酸转氨酶、碱性磷酸酶、γ-谷氨酰转移酶、5′-核苷酸酶活性进行测定与分析。结果肝胆疾病组丙氨酸氨基转移酶、天门冬氨酸氨基转移酶、乳酸脱氢酶、腺苷脱氨酶、线粒体天门冬氨酸转氨酶、碱性磷酸酶、γ-谷氨酰转移酶、5′-核苷酸酶活性均高于健康对照组（P〈0．01）。结论肝损伤酶活性联合检测有利于肝胆疾病的鉴别诊断及疗效观察。     

Genetic covariation between serum gamma-glutamyltransferase activity and cardiovascular risk factors

BACKGROUND: Several studies have shown that variation in serum gamma-glutamyltransferase (GGT) in the population is associated with risk of death or development of cardiovascular disease, type 2 diabetes, stroke, or hypertension. This association is only partly explained by associations between GGT and recognized risk factors. Our aim was to estimate the relative importance of genetic and environmental sources of variation in GGT as well as genetic and environmental sources of covariation between GGT and other liver enzymes and markers of cardiovascular risk in adult twin pairs. METHODS: We recruited 1134 men and 2241 women through the Australian Twin Registry. Data were collected through mailed questionnaires, telephone interviews, and by analysis of blood samples. Sources of variation in GGT, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) and of covariation between GGT and cardiovascular risk factors were assessed by maximum-likelihood model-fitting. RESULTS: Serum GGT, ALT, and AST were affected by additive genetic and nonshared environmental factors, with heritabilities estimated at 0.52, 0.48, and 0.32, respectively. One-half of the genetic variance in GGT was shared with ALT, AST, or both. There were highly significant correlations between GGT and body mass index; serum lipids, lipoproteins, glucose, and insulin; and blood pressure. These correlations were more attributable to genes that affect both GGT and known cardiovascular risk factors than to environmental factors. CONCLUSIONS: Variation in serum enzymes that reflect liver function showed significant genetic effects, and there was evidence that both genetic and environmental factors that affect these enzymes can also affect cardiovascular risk.     

The metabolic syndrome as predictor of type 2 diabetes: the San Antonio heart study

OBJECTIVE: The oral glucose tolerance test identifies high-risk subjects for diabetes, but it is costly and inconvenient. To find better predictors of type 2 diabetes, we evaluated two different definitions of the metabolic syndrome because insulin resistance, which is commonly associated with this clustering of metabolic factors, frequently precedes the onset of type 2 diabetes. RESEARCH DESIGN AND METHODS: We compared the ability of the National Cholesterol Education Program (NCEP) definition, a modified version of the 1999 World Health Organization (WHO) definition that excludes the 2-h glucose requirement, and impaired glucose tolerance (IGT) to predict incident type 2 diabetes. In the San Antonio Heart Study, 1734 participants completed a 7- to 8-year follow-up examination. RESULTS: IGT and the NCEP definition had higher sensitivity than the modified WHO definition (51.9, 52.8, and 42.8%, respectively). IGT had a higher positive predictive value than the NCEP and modified WHO definitions (43.0, 30.8, and 30.4%, respectively). The combination of the IGT and NCEP definitions increased the sensitivity to 70.8% with an acceptable positive predictive value of 29.7%. Risk for incidence of type 2 diabetes using the NCEP definition was independent of other risk factors, including IGT and fasting insulin (odds ratio 3.30, 95% CI 2.27-4.80). The NCEP definition performed better with fasting glucose >or=5.4 mmol/l (sensitivity 62.0% and positive predictive value 30.9%). CONCLUSIONS: The metabolic syndrome predicts diabetes independently of other factors. However, the NCEP definition performs better than the modified 1999 WHO definition. Lowering the fasting glucose cutoff to 5.4 mmol/l improves the prediction of diabetes by the metabolic syndrome.     

Alcohol consumption in relation to metabolic regulation, inflammation, and adiponectin in 64-year-old Caucasian women: a population-based study with a focus on impaired glucose regulation

OBJECTIVE: The aims of this study were to examine alcohol drinking patterns in women with type 2 diabetes, impaired glucose tolerance (IGT), and normal glucose tolerance (NGT) and to investigate whether alcohol intake was associated with improved insulin sensitivity, decreased biomarkers of inflammation, and increased adiponectin levels and if these effects were limited to dysmetabolic women. RESEARCH DESIGN AND METHODS: From a cohort of 64-year-old Caucasian women, 209 with type 2 diabetes, 205 with IGT, and 186 with NGT were recruited. Alcohol consumption and medication use were assessed by questionnaires. Anthropometric data were collected, and blood glucose, insulin, HDL cholesterol, triglycerides, C-reactive protein, white blood cell count, and serum adiponectin were measured. RESULTS: Compared with the NGT group, alcohol consumption was lower in the IGT group and lowest in the diabetes group. Mean alcohol intakes of >9.2 and > or =3-9 g/day were positively associated with adiponectin and insulin sensitivity (homeostasis model assessment [HOMA]), respectively, independently of obesity, metabolic control, and other confounders. Alcohol intake correlated negatively with inflammatory markers, although this did not remain after adjustment for HOMA and waist circumference. The inverse associations between alcohol consumption and factors related to the metabolic syndrome such as HOMA, waist circumference, and inflammatory markers were more obvious among women with diabetes and IGT than in healthy women. CONCLUSIONS: In these women, moderate alcohol consumption showed beneficial associations with the prevalence of type 2 diabetes, IGT, insulin sensitivity, and serum adiponectin. There is a need to clarify whether adiponectin may be a mechanistic link and also to clarify the clinical implications of these observations.     

Elevated liver function enzymes are related to the development of prediabetes and type 2 diabetes in younger adults: the Bogalusa Heart Study

OBJECTIVE

Elevations in alanine aminotransferase (ALT) and γ-glutamyl transferase (GGT), surrogate markers of liver dysfunction and nonalcoholic fatty liver, are considered as part of metabolic syndrome and related type 2 diabetes. However, information is limited regarding the long-term predictability of ALT and GGT in the development of prediabetes and type 2 diabetes.

RESEARCH DESIGN AND METHODS

In this retrospective cohort study, normoglycemic (n = 874), prediabetic (n = 101), and diabetic (n = 80) adults aged 26–50 years (average age 41.3 years) were followed over an average period of 16 years since their young adulthood (aged 18–38 years, average age 25.1 years), with measurements of cardiometabolic risk factor variables including ALT and GGT.

RESULTS

The follow-up prevalence rate of adult diabetes status by quartiles of baseline ALT and GGT levels showed an adverse trend for both prediabetes (P < 0.05) and diabetes (P < 0.01). In a longitudinal multivariate logistic regression analysis that included anthropometric, hemodynamic, and metabolic variables, as well as alcohol consumption and smoking, individuals with elevated baseline ALT and GGT levels (per 1-SD increment) were 1.16 and 1.20 times, respectively, more likely to develop diabetes (P = 0.05 for ALT and P < 0.01 for GGT); no such associations were noted for prediabetes. Regarding the predictive value of ALT and GGT, the area under the receiver operating curve analysis yielded C values ranging from 0.70 to 0.82, with values significantly higher for diabetes compared with prediabetes.

CONCLUSIONS

These findings in younger adults suggest potential clinical utility of including ALT and GGT as biomarkers in diabetes risk assessment formulations.Impaired glucose homeostasis is one of the most common causes of death in the U.S. (1). The progressive global epidemic of obesity has resulted in obesity being a major causal factor for prediabetes and type 2 diabetes (2,3). In addition, obesity-related nonalcoholic fatty liver disease (NAFLD) has reached epidemic proportions and has become the most common cause of chronic liver disease in Westernized populations (4). Increased activities of liver enzymes such as alanine aminotransferase (ALT) and γ-glutamyl transferase (GGT) are considered early surrogate markers of NAFLD (4,5). Studies also indicate that elevated activities of these enzymes are associated with metabolic syndrome and related clinical manifestations including cardiovascular disease and type 2 diabetes (4–11).Most studies of liver function enzymes related to metabolic syndrome and incident type 2 diabetes are mainly limited to middle- and older-aged populations (6–10). As part of the Bogalusa Heart Study, a biracial (black–white) community-based investigation of the early natural history of cardiovascular disease (12), the current study examines the association and potential predictability of ALT and GGT for the onset of type 2 diabetes in apparently healthy younger adults.     

血清GGT、ALT对2型糖尿病早期诊断价值的初步探讨

目的探讨血清γ-谷氨酰基转移酶（GGT）、丙氨酸氨基转移酶（ALT）对2型糖尿病早期诊断的临床应用价值。方法采用Roche Modu lar全自动生化分析仪及配套试剂检测200例2型糖尿病患者（男、女各100例）及200名正常对照者的血清葡萄糖（G lu）、GGT和ALT水平,并进行统计分析。结果 2型糖尿病患者男性及女性的G lu、GGT水平与对照组比较,差异均有统计学意义（P〈0.05）,而ALT则无差异;男性和女性2型糖尿病患者中GGT浓度超出参考区间的百分率分别是13%和16%,明显高于对照组。结论 GGT对于2型糖尿病的早期诊断有一定意义。     

Bauhinia variegata (Caesalpiniaceae) leaf extract: An effective treatment option in type I and type II diabetes

Among various metabolic disorders, diabetes mellitus is one of the most common disorder. Present study was designed to evaluate the effectiveness of aqueous extract of Bauhinia variegata leaves (AE) in animal models of type I and type II diabetes.Type I diabetes was induced by streptozotocin at the dose of 55 mg/kg (i.p.) in male Sprague Dawley rats while type II diabetes was induced by high fat diet and streptozotocin at the dose of 35 mg/kg (i.p.). Diabetic animals were treated with AE at the dose of 250, 500 and 1000 mg/kg. Glipizide (5 mg/kg) was used as standard treatment drug. Treatment was given for 28 days. Parameters evaluated were body weight, plasma glucose, cholesterol, triglyceride, aspartate aminotransferase, alanine transaminase, alkaline phosphatase, total proteins, albumin, creatinine and bun urea nitrogen. In type II diabetes, high density lipoprotein levels in plasma and plasma insulin level were also evaluated. Histopathological study of pancreases were carried out in type I study.AE showed significant decrease in plasma glucose significantly. AE was also found to decrease cholesterol, triglyceride, creatinine and blood urea nitrogen level in both types of diabetes. AE did not show any significant effect on plasma levels of aspartate aminotransferase, alanine transaminase, alkaline phosphatase. AE was found to increase the albumin and total protein levels. Histopathological study showed that AE decreases the necrotic changes in the pancreatic tissue.Aqueous extract of B. variegata leaves was found effective in treatment of both type I and type II diabetes.     

血清GGT、ALT对2型糖尿病早期诊断价值的初步探讨

目的探讨血清γ-谷氨酰基转移酶(GGT)、丙氨酸氨基转移酶(ALT)对2型糖尿病早期诊断的临床应用价值。方法采用Roche Modu lar全自动生化分析仪及配套试剂检测200例2型糖尿病患者(男、女各100例)及200名正常对照者的血清葡萄糖(G lu)、GGT和ALT水平,并进行统计分析。结果 2型糖尿病患者男性及女性的G lu、GGT水平与对照组比较,差异均有统计学意义(P<0.05),而ALT则无差异;男性和女性2型糖尿病患者中GGT浓度超出参考区间的百分率分别是13%和16%,明显高于对照组。结论 GGT对于2型糖尿病的早期诊断有一定意义。     

Cardiovascular morbidity and mortality associated with the metabolic syndrome

OBJECTIVE: To estimate the prevalence of and the cardiovascular risk associated with the metabolic syndrome using the new definition proposed by the World Health Organization RESEARCH DESIGN AND METHODS: A total of 4,483 subjects aged 35-70 years participating in a large family study of type 2 diabetes in Finland and Sweden (the Botnia study) were included in the analysis of cardiovascular risk associated with the metabolic syndrome. In subjects who had type 2 diabetes (n = 1,697), impaired fasting glucose (IFG)/impaired glucose tolerance (IGT) (n = 798) or insulin-resistance with normal glucose tolerance (NGT) (n = 1,988), the metabolic syndrome was defined as presence of at least two of the following risk factors: obesity, hypertension, dyslipidemia, or microalbuminuria. Cardiovascular mortality was assessed in 3,606 subjects with a median follow-up of 6.9 years. RESULTS: In women and men, respectively, the metabolic syndrome was seen in 10 and 15% of subjects with NGT, 42 and 64% of those with IFG/IGT, and 78 and 84% of those with type 2 diabetes. The risk for coronary heart disease and stroke was increased threefold in subjects with the syndrome (P < 0.001). Cardiovascular mortality was markedly increased in subjects with the metabolic syndrome (12.0 vs. 2.2%, P < 0.001). Of the individual components of the metabolic syndrome, microalbuminuria conferred the strongest risk of cardiovascular death (RR 2.80; P = 0.002). CONCLUSIONS: The WHO definition of the metabolic syndrome identifies subjects with increased cardiovascular morbidity and mortality and offers a tool for comparison of results from diferent studies.