农村人群肝功能酶流行病学分布特征及相关因素分析

目的探讨农村人群血清肝功能酶,包括丙氨酸氨基转移酶（ALT）、门冬氨酸氨基转移酶（AST）和谷氨酰转肽酶（GGT）的流行病学分布特点及影响因素。方法采用整群抽样的方法,选取宜兴市官林镇都山村年龄≥30岁共3000人作为调查对象,设计统一的调查表,对参与调查的2237人进行问卷调查,收集流行病学资料并进行体格检查,同时检测血清ALT、AST、GGT、血脂和血糖等生化指标。结果 （1）本次调查共有1673例纳入分析,ALT、AST和GGT水平在男女之间差异均有统计学意义（t=2.638,P〈0.01;t=3.719,P〈0.01;t=4.579,P〈0.01）。（2）随着年龄的增长,男性ALT和GGT水平呈现下降趋势。（3）总体上男女之间ALT和GGT的异常率（≥40 U/L）差异均有统计学意义（χ2=6.150,P〈0.05;χ2=32.928,P〈0.01）,而AST异常率差异无统计学意义（χ2=1.993,P=0.158）。男性ALT和GGT异常率均随年龄增高而逐渐降低（χ2=15.700,P〈0.01;χ2=25.069,P〈0.01）,而女性60-70岁组GGT异常率最高（χ2=10.790,P〈0.05）。（4）单因素分析显示,除年龄和性别外,影响ALT、AST和GGT升高的因素为总胆固醇（TC）、三酰甘油（TG）、尿酸（UA）和体质量指数（BMI）。（5）多因素Logistic回归分析显示,年龄、BMI、TG和UA均与ALT升高相关,TC和UA与AST升高相关,而性别、年龄、BMI、TC、TG、低密度脂蛋白胆固醇（LDL-C）、UA、肌酐（CR）、空腹血糖（FBG）和饮酒均与GGT升高相关。结论随着年龄的增加,农村人群血清ALT和GGT在男性中都呈现下降趋势,肝功能酶水平的升高受到BMI、血脂、血糖、UA水平及饮酒等多因素的影响。

A survey on epidemiological distribution of plasma levels of liver function markers and its influencing factors in rural population

Objective To investigate the epidemiological characteristics and the risk factors of plasma alanine amin- otransferase （ALT）, aspartate aminotransferase （AST） and gamma-glutamyltransferase （GGT） in rural population. Methods A cross-section study was conducted for the target population of 3,000 people aged 30 years old and over in DuShan village, GuanLin township of Yixing city. A cluster sampling method was used and 2237 people underwent the measurement of height, weight, blood pressure, total cholesterol （TC）, triglycerides （TG）, low density lipoprotein cholesterol （LDL-C）, high density lipoprotein cholesterol （HDL-C）, fasting blood glucose （FBG）, uric acid （UA）. Results （ 1 ） 1673 people were included in the present study. The levels of ALT, AST and GGT in male were （ 22. 2± 14. 5） U/ L, （23.9±11.8） U/Land （36.9±78.7） U/L, compared with （20.0±18.9） U/L, （21.8±10.6） U/L and （23.6±24.0） U/L in female （t=2.638, P〈0.01; t=3.719, P〈 0. 01 ; t=4. 579, P〈0.01） respectively. （2） With the increase of age, the levels of ALT and GGT were significantly decreased in male. （3） There was significant difference of abnormal proportions of ALT and GGT （ ≥40 U/L） between male and female whereas no difference found in AST. Abnormal proportions of ALT and GGT significantly decreased with the increase of age （X2= 15. 700, P〈0.01; X2=25.069, P〈0.01）, and 60- years group showed highest abnormal GGT proportion （X2 = 10. 790, P= 0. 013）. （4） Univariate analysis indicated that the increase of the aminotransferases was significantly associated with TC, TG, UA, BMI, gender and age. （5） Multiple Lo- gistic regressions showed that age, BMI, TG and UA were significantly associated with elevated ALT, TC and UA signifi- cantly associated with elevated AST, and age, gender, BMI, TC, TG, LDL-C, UA, Cr, FBG and drinking significantly associated with elevated GGT. Conclusions ALT and GGT in men significantly decrease with the increase