摘要
目的探究2型糖尿病和空腹血糖受损与丙氨酸氨基转移酶(alanine aminotransferase, ALT)、天冬氨酸转氨酶(aspartate aminotransferase, AST)的关系,为后续因果关联性研究提供参考。方法采用便利抽样方法,选取2017年1月至2018年9月,甘肃省慢性病健康管理系统体检的对象,利用系统内完善的个人基本信息(性别、年龄、乡镇等)及健康体检结果(空腹静脉血血糖、ALT、AST、血压、甘油三酯、总胆固醇等指标)进行分析。结果研究总共涉及未使用过药物的对象1 528人,包括非糖尿病1 034例,空腹血糖受损183例,糖尿病311例。非糖尿病人群中ALT、AST异常的比例分别为7.98%、8.71%,而糖尿病人群中的ALT、AST异常的比例达到13.06%、17.53%,空腹血糖受损人群居中(11.80%、14.61%),差异有统计学意义(P<0.01);Logistic回归结果显示,调整了性别、年龄、BMI、血脂等混杂因素后,糖尿病人群较非糖尿病人群ALT异常(OR=1.53,P=0.046)、AST异常(OR=2.01,P<0.01)、AST/ALT异常(OR=1.41,P=0.013)的风险更高;与非糖尿病人群相比,空腹血糖受损人群的AST/ALT异常的风险更高,差异有统计学意义(OR=1.58,P=0.008)。结论空腹血糖受损、糖尿病人群较非糖尿病人群的ALT、AST、AST/ALT异常的可能性更大,应对其因果关联进行探索,为降低2型糖尿病人群肝脏损伤的风险提供科学证据。
Objective To explore the correlation between type 2 diabetes mellitus, impaired fasting glucose and liver function index as alanine aminotransferase(ALT) and aspartate aminotransferase(AST). Methods We used convenient sampling method to select subjects recorded in Gansu Provincial Chronic Disease Health Management System between January 2017 and September 2018.The basic personal information(gender, age, township, etc.) and physical examination results(fasting venous blood glucose, ALT, blood pressure, AST, triglycerides, total cholesterol, etc.) of selected subjects were retrieved from the system and used for analysis.2 test and logistic regression were performed to assess the correlation between type 2 diabetes mellitus, impaired fasting glucose and ALT, AST. Results A total of 1 528 untreated subjects were selected, including 1 034 with non-diabetes, 183 with impaired fasting glucose and 311 with diabetes.The percentages of ALT and AST abnormalities were the lowest in nondiabetic subjects( 7.98% and 8.71%) and the highest in diabetic subjects(13.06% and 17.53%), they were 11.80% and 14.61% in subjects with impaired fasting blood glucose, the differences were statistically significant(P<0.01).After adjusting for confounding factors as gender, age, BMI and blood fat, logistic regression analysis showed that the risk of abnormalities of ALT (OR=1.53,P=0.046),AST(OR=2.01,P<0.01)and AST/ALT ratio(OR=1.41,P=0.013)were higher in subjects with diabetes than in non-diabetic subjects.Compared with non-diabetic subjects,the risk of abnormalities of AST/ALT ratio were higher in subjects with impaired fasting glucose and with diabetes(OR=1.58,P=0.008),and the differences were statistically significant. Conclusions Individuals with impaired fasting glucose or diabetes are more likely to be abnormal in ALT,AST and ALT/ALT ratio compared to those with non-diabetes.The causal associations should be explored to provide scientific evidence for reducing the risk of liver damage in diabetic populations.
作者
韩冰峰
杨树博
张入学
崔富强
HAN Bing-feng;YANG Shu-bo;ZHANG Ru-xue;CUI Fu-qiang(School of Public Health , Peking University , Beijing 100191 , China)
出处
《中国预防医学杂志》
CAS
CSCD
2019年第6期505-509,共5页
Chinese Preventive Medicine
基金
“艾滋病和病毒性肝炎等重大传染病防治”科技重大专项(2018ZX10721202)
北京大学医学部专项(BMU20170607)
