-谷氨酰转肽酶水平与代谢综合征及其组分间关系

目的 了解γ-谷氨酰转肽酶（GGT）水平与代谢综合征（MS）及其组分之间的关系，为临床工作中利用GGT水平诊断MS提供科学依据。方法 采用立意抽样方法收集北京市小汤山医院2012年1-12月28 057名体检人群的体检资料，采用Pearson相关分析GGT水平与MS相关组分之间的相关性，将按照GGT水平四分位数法分为<13.0、13.0~19.0、19.1~31.0、>31.0 U/L 4组进行二分类logistic回归模型分析不同GGT水平与MS发生风险之间的关系，应用受试者工作特征曲线（ROC）分析GGT水平诊断MS的最佳临界值。结果 MS组人群的GGT水平为（40.96±4.17） U/L，高于非MS组人群的（24.10±2.49） U/L，差异有统计学意义（t=-27.048，P<0.01）；两变量Pearson相关分析以及调整了性别、年龄和MS其他组分后的偏相关分析结果显示，GGT水平与体质指数、收缩压、舒张压、空腹血糖、甘油三酯MS组分均呈正相关（均P<0.01），与高密度脂蛋白胆固醇MS组分均呈负相关（均P<0.01）；在控制了性别和年龄等混杂因素后，二分类logistic回归分析结果显示，GGT 13.0~19.0 U/L组、19.1~31.0 U/L组、>31.0 U/L组人群MS发病风险分别为GGT<13.0 U/L组人群的1.247倍（OR=1.247，95%CI=1.133~1.374）、2.375倍（OR=2.375，95%CI=2.166~2.605）、4.729倍（OR=4.729，95%CI=4.323~5.173）；ROC曲线结果显示，男性和女性GGT水平诊断MS的ROC曲线下面积分别为0.687和0.747，诊断MS的截断值分别为24.5和13.5 U/L，灵敏度分别为0.715和0.806，特异度分别为0.563和0.580。结论 GGT水平与MS及其组分之间存在相关关系，GGT水平的升高能够增加MS的发生风险，可作为MS发生的标志物。

Association of -glutamyltransferase with metabolic syndrome and its components

Objective To explore the association of γ-glutamyltransferase (GGT) with metabolic syndrome (MS) and its components and to provide scientific evidence for diagnosis of MS by GGT level in clinical practice.Methods Purposive sampling was used to extracted medical records of 23 269 persons taking physical examination at Beijing Xiaotangshan Hospital from January through December of 2012.Pearson correlation analysis was adopted to analyze the correlation between GGT and components of MS.Binary logistic analysis was applied to evaluate the risk of MS in relation to GGT level among the participants with various GGT level (divided into quartiles of<13.0,13.0-19.0,19.1-31.0,and >31.0 U/L).Receiver operating characteristic (ROC)analysis was applied to determine an optimal cut-off value of GGT for the diagnosis of MS.Results The GGT level in the participants with MS was significantly higher than that in those without MS (40.96±41.74 vs.24.10±24.86,t=-27.048;P<0.01).Pearson analysis showed that there were positive significant correlations between GGT level and body mass index,systolic blood pressure,diastolic blood pressure,fasting plasma glucose,and triglyceride (all P<0.01)and a significant inverse correlation between GGT level and high density lipoprotein (P<0.01)after adjusting for age and sex.The results of binary logistic analysis revealed that the risk of MS increased with the increment of GGT level,with the odds ratios (95%confidence intervals) of 1.247 (1.133-1.374)for the participants with GGT of 13.0-19.0/L,2.375 (2.166-2.605)for 19.1-31.0/L,and 4.729 (4.323-5.173)for >31.0/L 9,after adjusting for age and gender,respectively.ROC analyses revealed that for the prediction of MS with GGT level among the male and female participants,the mean area under the curve was 0.687 and 0.747 and the optimal cut-off value of GGT are 24.5 and 13.5 U/L,with the sensitivity of 0.715 and 0.806 and the specificity of 0.563 and 0.580,respectively.Conclusion The GGT level correlates to MS and its components and increased GGT level may increase the risk of MS,suggesting that GGT could be used as a predictor of MS.