基于倾向性评分探析肝功能评估不同性别代谢综合征的价值研究

目的 基于倾向性评分匹配(PSM)探讨肝功能指标对代谢综合征(MS)的评估价值，评估其是否可作为筛查MS的简易指标。方法 选取2016年于新疆乌鲁木齐市某体检机构体检者25244例为研究对象，采用PSM控制混杂因素，性别分层下比较MS与非MS组肝酶及胆红素的差异，进一步分析其与MS患病的关联，并绘制肝功能指标评估MS的受试者工作特征曲线。结果 经PSM后除TBIL外，MS患者GGT、AST、ALT、ALP均高于非MS人群，多元logistic回归结果显示，高水平的GGT、ALT是MS患病的危险因素，低水平的TBIL、高水平的ALP仅是女性人群MS患病的危险因素，GGT评估MS较好，男女性最佳临界值分别为24.5 U/L和19.5 U/L。结论 即使在正常范围内高水平的GGT、ALT是MS的危险因素，可作为MS早期鉴别的生物学标志物，为MS及慢性病的前期预防提供参考。

Predictive value of liver function in metabolic syndrome of different gender based on ProPensity score matching

To compare the predictive value of liver function index in MS and to determine a simple screening indicator for MS. Methods A total of 25 244 health examinees were selected from a physical examination center in Urumqi, Xinjiang in 2016. PSM was used to control the confounding factors, and the differences of liver enzymes and bilirubin between MS and non-MS groups were compared under gender stratification. Further analysis of liver function indicators on the impact of MS was conducted and the subject working characteristic curve was drawn. Results After PSM, GGT, AST, ALT and ALP in MS patients were higher than those in non-MS population, while TBIL was not. Multivariate logistic regression analysis showed that high levels of GGT and ALT were risk factors for MS, while low levels of TBIL and high levels of ALP were only risk factors for MS in female population. GGT was better in the evaluation of MS, and the best critical values for male and female were 24.5 U/L and 19.5 U/L. Conclusion Even in the normal range, high levels of GGT and ALT are risk factors for MS, which can be used as biomarkers for the early identification of MS and provide reference for the early prevention of MS and chronic diseases.