5857例健康体检者血清谷丙转氨酶与代谢综合征的相关性探讨

目的 探讨血清谷丙转氨酶(ALT)在正常值范围内轻度升高对代谢综合征(MetS)的预警作用.方法 收集2011年3月至2011年10月在南京南钢医院体检中心进行健康体检的企业职工健康体检资料.体检项目包括体重指数、腰围、血压、空腹血糖、谷丙转氨酶、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇等.依据改良的NCEP-ATPⅢ定义的MetS诊断标准,比较不同ALT值MetS的发病率.结果 符合入组标准的研究对象共5 857例,其中男性4 379例(74.8％),女性1 478例(25.2％).该人群代谢综合征患病率为13.1％,(男16.5％,女2.9％).MetS组ALT异常者(＞40 U/L) 258例占33.9％,非MetS组ALT异常者(＞40 U/L) 503例占9.88％,两组比较差异有统计学意义.健康体检人群中MetS组患者个体ALT水平升高为(39.30±26.91) IU/L,而非MetS组ALT水平为(22.51±16.77) IU/L,两组比较差异有统计学意义.随着ALT值的增加,Mets发病率增加.结论 ALT异常者中MetS发病率明显增高;ALT值在正常值范围内,随着ALT值的增加,Mets的发病率也逐渐增加.通过ROC曲线获得ALT截止值为23.55 IU/L,较现行临床正常参考值对Mets有更好的预警效果.

Correlation analysis of serum alanine aminotransferase and metabolic syndrome in 5 857 healthy individuals

Objective To investigate the correlation between the slight increase of alanine aminotransferase (ALT) in normal range and metabolic syndrome (MetS). Methods The clinical data of the healthy individuals undergoing physical examination in the Examination Center of Nangang Hospital of Nanjing City from March 2011 to October 2011 were collected, including body mass index (BMI), waistline, blood pressure, fasting plasma glucose, ALT, Triglycerides, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol. The diagnostic criteria of MetS was designed according to modified NCEP ATP III criteria. The incidences of MetS corresponding to difference AlT were compared. Results A total of 5 857 individuals were selected, including 4 379 males (74.8%) and 1 478 females (25.2%). The total incidence of MetS was 13.1%. The incidence of MetS was 16.5% for the males and 2.9% for the females. 258 cases (33.9%) in the MetS group had abnormal ALT levels (>40 U/L), and 503 cases (9.88%) in the non-MetS group had abnormal ALT levels (>40 U/L), showing statistically significant difference between the two groups. The level of ALT was (39.30±26.91) IU/L in the MetS group, significantly higher than (22.51±16.77) IU/L in the non-MetS group. As the levels of ALT increased, the incidence of MetS increased. Conclusion In incidence of MetS is increased in the patients with abnormal ALT levels. The cut-off value of ALT is 23.55 IU/L, which plays greater warning role in the diagnosis of MetS than the normal reference values.