AIM: To investigate the association between liver markers and the risk of type 2 diabetes(T2DM) and impaired fasting glucose(IFG).METHODS: A total of 8863 participants(3408 men and 5455 women) over 30 years of age wer...AIM: To investigate the association between liver markers and the risk of type 2 diabetes(T2DM) and impaired fasting glucose(IFG).METHODS: A total of 8863 participants(3408 men and 5455 women) over 30 years of age were analyzed from the fifth Korean National Health and Nutrition Examination Survey(2010-2011). The associations of serum liver markers such as aspartate aminotransferase(AST), alanine aminotransferase(ALT), AST/ALT, and gamma-glutamyltransferase(GGT) with T2 DM and IFG were analyzed using logistic regression models. Participants were divided into sex-specific quartiles on the basis of liver markers.RESULTS: The prevalence of T2 DM and IFG were 11.3% and 18.3%. Increasing quartiles of ALT and GGT were positively and AST/ALT were negatively correlated with T2 DM and IFG. Analysis of the liver marker combinations showed that if any two or more markers were in the highest risk quartile, the risks of both T2 DM and IFG increased significantly. The risk was greatest when the highest ALT and GGT and lowest AST/ALT quartile were combined, with the riskof T2 DM at 3.21(95%CI: 1.829-5.622, P < 0.001) in men and 4.60(95%CI: 3.217-6.582, P < 0.001) in women. Men and women with the highest AST and ALT and lowest AST/ALT quartile had a 1.99 and 2.40 times increased risk of IFG.CONCLUSION: Higher levels of GGT and ALT and lower AST/ALT within the physiological range are independent, additive risk factors of T2 DM and IFG.展开更多
基金the Division of Chronic Disease Surveillance of the Korean Center for Disease Control and Prevention who conducted the national survey and everyone who contributed to this project
文摘AIM: To investigate the association between liver markers and the risk of type 2 diabetes(T2DM) and impaired fasting glucose(IFG).METHODS: A total of 8863 participants(3408 men and 5455 women) over 30 years of age were analyzed from the fifth Korean National Health and Nutrition Examination Survey(2010-2011). The associations of serum liver markers such as aspartate aminotransferase(AST), alanine aminotransferase(ALT), AST/ALT, and gamma-glutamyltransferase(GGT) with T2 DM and IFG were analyzed using logistic regression models. Participants were divided into sex-specific quartiles on the basis of liver markers.RESULTS: The prevalence of T2 DM and IFG were 11.3% and 18.3%. Increasing quartiles of ALT and GGT were positively and AST/ALT were negatively correlated with T2 DM and IFG. Analysis of the liver marker combinations showed that if any two or more markers were in the highest risk quartile, the risks of both T2 DM and IFG increased significantly. The risk was greatest when the highest ALT and GGT and lowest AST/ALT quartile were combined, with the riskof T2 DM at 3.21(95%CI: 1.829-5.622, P < 0.001) in men and 4.60(95%CI: 3.217-6.582, P < 0.001) in women. Men and women with the highest AST and ALT and lowest AST/ALT quartile had a 1.99 and 2.40 times increased risk of IFG.CONCLUSION: Higher levels of GGT and ALT and lower AST/ALT within the physiological range are independent, additive risk factors of T2 DM and IFG.
文摘目的 探讨谷氨酰转肽酶(gamma-glutamyl transferase,GGT)<300 U/L临床疑诊为胆道闭锁患儿的临床特征。方法 收集2012年6月至2018年9月由广西医科大学第一附属医院儿科转至小儿外科收治的GGT<300 U/L临床疑诊为胆道闭锁的84例患儿的临床资料,根据术中胆道造影的诊断结果分为胆道闭锁组和胆汁淤积性肝炎组;其中确诊胆道闭锁33例(胆道闭锁组),39.29%(33/84),胆汁淤积性肝炎51例(胆汁淤积性肝炎组),60.71%(51/84)。分析两组患儿在肝功能、胆固醇、血乳酸、血氨、血常规和肝脏病理学等方面的特点和差异。结果 胆道闭锁组就诊日龄及手术日龄显著高于胆汁淤积性肝炎组,差异具有统计学意义(P<0.05)。胆道闭锁组GGT、总胆汁酸(total bile acid,TBA)值显著高于胆汁淤积性肝炎组,差异具有统计学意义(P<0.05)。GGT和TBA的曲线下面积(area under the curve,AUC)分别为0.715和0.72;GGT、TBA值两项指标联合分析,AUC为0.739,诊断价值均为中等,所得阈值灵敏性及特异性均不高。胆道闭锁组肝纤维化的比例显著高于胆汁淤积性肝炎组,其中21.21%(7/33)的胆道闭锁患儿存在肝硬化,所有胆汁淤积性肝炎组的患儿无肝硬化,胆道闭锁组肝纤维化程度与就诊日龄、GGT呈正相关(R=0.503,F=6.321,P=0.001)。胆道闭锁肝组织胆栓形成和胆管增生均显著高于胆汁淤积性肝炎(P<0.05)。结论 GGT<300 U/L的疑似胆道闭锁的患儿,建议早期进行肝组织病理学检查或剖腹探查提高诊断的准确率。
