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目的:探讨中老年人群中不同糖代谢水平者的血清γ-谷氨酰转肽酶(gamma-glutamyltranspeptidase,GGT)水平差异,并分析其与糖尿病前期[即糖调节受损(impaired glucose regulation,IGR)]及糖尿病(diabetes mellitus,DM)患病风险间的关系。方法:采用整群抽样的方法,对甘肃省兰州市五泉铁路西村社区40~75岁的常住居民进行问卷调查、体格检查和生化检测;将人群分为正常糖耐量(normal glucose tolerance,NGT)组、IGR组及DM组,比较3组人群血清GGT水平的差异,并分析GGT水平与IGR及DM患病风险间的关系。结果:1DM组的GGT水平明显高于NGT及IGR组(P均<0.01)。协方差分析显示,校正性别、年龄、饮酒等多种影响因素后,DM组的GGT水平仍明显高于NGT及IGR组(P均<0.01)。2Spearman相关分析显示,血清GGT水平与三酰甘油(triglyceride,TG)、腰围和餐后2 h血糖(two hours postprandial blood glucose,2h PG)的关系较为密切(r值分别为0.357、0.312、0.280,P均<0.01);校正性别、年龄、体质量指数、腰围和饮酒的影响后,血清GGT水平与血糖指标(空腹血糖、2h PG、糖化血红蛋白)、血脂指标(低密度脂蛋白胆固醇、总胆固醇、TG)呈正相关(P均<0.01)。3Logistic回归分析显示,IGR、DM患病风险随着血清GGT水平的升高而增加,校正多种影响因素后,GGT>69 u/L组的IGR患病风险是GGT四分位水平最低组的2.296倍(95%CI为1.062~4.967,P<0.05),且其DM患病风险是GGT四分位水平最低组的4.399倍(95%CI为2.020~9.579,P<0.01)。结论:甘肃省兰州市五泉铁路西村社区40~75岁常住居民中,血清GGT水平异常者的IGR患病风险升高,且随着血清GGT水平的升高,DM患病风险亦增加,而GGT异常者的DM患病风险升高明显。结果提示该人群中血清GGT水平异常与糖代谢异常患病风险升高显著相关。
OBJECTIVE: To investigate the difference of serum GGT levels among people with different levels of glucose metabolism in the middle-aged and elderly population and to analyze their association with pre-diabetes [impaired glucose regulation (IGR )] And the risk of diabetes mellitus (DM). Methods: A cluster sampling method was used to conduct questionnaire, physical examination and biochemical tests on residents aged 40-75 years in Nishimura community of Wensan Railway in Lanzhou City, Gansu Province. The population was divided into normal glucose tolerance (NGT) group , IGR group and DM group. The differences of serum GGT levels between the three groups were compared, and the relationship between GGT level and risk of IGR and DM was analyzed. Results: The GGT level in 1DM group was significantly higher than that in NGT and IGR group (all P <0.01). Covariance analysis showed that GGT levels in DM group were still significantly higher than those in NGT and IGR groups (P <0.01) after adjusting for gender, age, alcohol consumption and other factors. 2Spearman correlation analysis showed that serum GGT level was closely related to triglyceride (TG), waist circumference and two hours postprandial blood glucose (2h PG) (r = 0.357,0.312,0.280, P <0.01). After adjusting for gender, age, body mass index, waist circumference and alcohol consumption, serum GGT levels were positively correlated with the level of blood glucose (fasting blood glucose, 2h PG and glycosylated hemoglobin), blood lipid (LDL cholesterol, total cholesterol , TG) (all P <0.01). 3 Logistic regression analysis showed that the risk of IGR and DM increased with the increase of serum GGT level. After adjusting for various factors, the risk of IGR in GGT> 69 u / L group was the lowest in GGT quartile (95% CI: 1.062 ~ 4.967, P <0.05), and the risk of DM was 4.399 times (95% CI: 2.020 ~ 9.579, P <0.01) of the lowest GGT tertile. CONCLUSIONS: The prevalence of IGR in those aged 40-75 years with abnormal serum GGT levels in Xicun Community, Lanzhou City, Gansu Province, is increased. The risk of DM is also increased with the increase of serum GGT level. However, GGT Abnormal DM risk increased significantly. The results suggest that abnormal serum GGT levels in this population are significantly associated with an increased risk of abnormal glucose metabolism.