中老年人血清丙氨酸氨基转移酶水平与代谢综合征的相关性研究

目的 研究中老年人血清丙氨酸氨基转移酶(ALT)水平与代谢综合征的相关性.方法 对上海市宝山区友谊街道1 664名40岁以上居民进行问卷调查、体格检查以及空腹采血检测肝肾功能、血糖及血脂等生化指标.代谢综合征采用按照亚洲人特点改良的美国国家胆固醇教育计划成人治疗组第三次报告(NCEP-ATP Ⅲ)诊断标准.结果 研究对象各主要代谢指标均随着ALT水平的升高而逐渐趋向恶化.代谢综合征的患病率从第一个ALT四分位至第四个ALT四分位分别为29.2%、38.0%、44.9%和62.9%(组间趋势P<0.01).血清ALT水平与代谢综合征及其多个组分的患病风险之间存在显著的剂量一反应关系.相比ALT水平在第一个四分位的研究对象,ALT水平在第四个四分位的研究对象代谢综合征患病风险增加146%,中心性肥胖风险增加204%,高血压风险增加35%,高甘油三酯风险增加133%,高血糖风险增加72%.另外,随着代谢综合征组分个数的增加,ALT水平显著上升(组间趋势P<0.01).结论 中老年人血清ALT水平升高增加代谢综合征的患病风险.

Association of serum alanine aminotransferase with metabolic syndrome in middle-aged and elderly Chinese

Objective To investigate the association between levels of serum alanine aminotransferase (ALT) and the risks of metabolic syndrome in middle-aged and elderly Chinese. Methods After excluding subjects with known liver disease, excess alcohol consumption and serum ALT≥40 IU/L,1 664 subjects aged 40 years or older from Baoshan Community, Shanghai were recruited to undergo questionnaire interview, anthropometric measurements, and fasting blood sampling. Biochemical features were evaluated and the metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) criteria with modification on waist circumference cutoff which is more appropriate for an Asian population. Results Increased ALT levels were associated with more unfavorable metabolic risk profiles. The prevalence rates of the metabolic syndrome in participants with increasing ALT quartiles were 29. 2% , 38. 0% , 44.9% , and 62. 9% , respectively (P for trend <0. 01 ). ALT concentrations were significantly elevated with increasing number of the metabolic syndrome components (P for trend<0.01). Serum ALT levels were significantly associated with the risks of metabolic syndrome and most of its components in a dose-response manner. As compared with participants in the first ALT quartile, the risks of metabolic syndrome were increased by 146% , central obesity by 204% , hypertension by 35% , high triglycerides by 133% , and hyperglycemia by 72% in participants of the fourth ALT quartile. Conclusions A high-normal serum ALT level was significantly associated with an increased risk of the metabolic syndrome in middle-aged and elderly Chinese.