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目的探讨宁夏回汉人群血清中转氨酶活性与代谢综合征(metabolic syndrome,MS)及其相关指标的关系。方法采用病例-对照研究方法,2011年10月—2012年10月期间在宁夏医科大学附属医院及吴忠市人民医院进行定期健康体检人群中,筛选出877例无血缘关系的代谢综合征患者为病例组和655名无血缘关系的健康人为对照组。通过问卷方式调查研究对象的一般情况、生活方式、疾病及用药史、家族史等情况,通过体格检查测量研究对象的身高、体重、腰围、臀围及血压等。采集空腹静脉血进行实验室生化指标检测,包括空腹血糖(FPG)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)等。采用χ2检验、t检验和方差分析研究指标与MS患病的关系。结果病例组AST和ALT平均水平(t=-3.971,t=-6.048,P<0.01)及异常率(χ2=11.556,χ2=33.231,P<0.01)均高于对照组,差异有统计学意义。以对照组人群AST、ALT水平的75%以及40 U/L为界将研究对象分为低、中、高三组,调整性别、年龄、民族、文化程度、吸烟、饮酒等因素后,AST、ALT中水平人群MS患病风险分别是低水平人群的1.663倍(95%CI 1.263~2.189)和2.126倍(95%CI 1.586~2.852),高水平人群是低水平人群的2.801倍(95%CI 1.696~4.624)和4.918倍(95%CI 2.980~8.116),高水平人群是低水平+中水平人群的2.517倍(95%CI 1.530~4.142)和4.194倍(95%CI 2.554~6.885)。随着代谢综合征组分数量的增加,AST和ALT平均水平逐渐增加,差异均有统计学意义(F=7.742,F=11.753,P<0.01)。不同年龄组间AST和ALT平均水平除对照组外,其余组间差异均有统计学意义(P<0.05)。回族AST和ALT平均水平虽高于汉族,但差异均无统计学意义。男性AST、ALT平均水平均明显高于女性,除病例组AST水平外,其余组别差异均有统计学意义(P<0.01)。不同BMI水平间AST和ALT平均水平差异均有统计学意义(P<0.05)。结论 AST、ALT平均水平与MS的患病密切相关,正常范围内AST、ALT水平的偏高即可增加MS的患病风险,异常增高者MS患病风险的增加更为显著。AST、ALT水平可能成为预测MS患病、综合评价MS危险因素以及MS进展情况的重要因子。
Objective To investigate the relationship between serum aminotransferase (ALT) activity and metabolic syndrome (MS) and its related indexes in Ningxia Hui and Han Chinese. Methods A case-control study was conducted. From October 2011 to October 2012, 877 unrelated patients with metabolic syndrome were screened out from regular health examination in Affiliated Hospital of Ningxia Medical University and Wuzhong People’s Hospital. Group and 655 non-related healthy people as control group. By questionnaire survey of the general situation of subjects, lifestyle, illness and medication history, family history and other conditions through the physical examination of the study object height, weight, waist circumference, hip circumference and blood pressure. Fasting venous blood was collected for laboratory biochemical detection, including fasting blood glucose (FPG), triglyceride (TG), total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL- C), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and the like. Chi-square test, t-test and ANOVA were used to investigate the relationship between the index and the prevalence of MS. Results The average levels of AST and ALT in the case group were significantly higher than those in the control group (t = -3.971, t = -6.048, P <0.01) and abnormalities (χ2 = 11.556, χ2 = 33.231, P <0.01) . After adjusting for sex, age, ethnicity, education level, smoking, drinking and other factors, the subjects were divided into low, middle and high groups according to the level of AST and ALT of 75% and 40 U / The prevalence of MS in middle-level population was 1.663-fold (95% CI 1.263-2.18) and 2.126-fold (95% CI 1.586-2.852), respectively, and 2.801-fold (95% CI 1.696) for low-level population ~ 4.624) and 4.918 times (95% CI 2.980 ~ 8.116). The high-level population was 2.517 times (95% CI 1.530 ~ 4.142) and 4.194 times (95% CI 2.554 ~ 6.885), respectively. With the increase of the number of metabolic syndrome components, the average levels of AST and ALT gradually increased, the differences were statistically significant (F = 7.742, F = 11.753, P <0.01). The average levels of AST and ALT in different age groups except the control group, the other groups were statistically significant differences (P <0.05). Although the average level of Hui and AST in Hui nationality is higher than that in Han nationality, the differences are not statistically significant. The average levels of AST and ALT in males were significantly higher than those in females, except for the level of AST in the cases, the differences were statistically significant (P <0.01). There were significant differences in mean AST and ALT between different BMI levels (P <0.05). Conclusions The average levels of AST and ALT are closely related to the prevalence of MS. Elevated levels of AST and ALT in the normal range can increase the risk of MS, and the increase of MS in patients with abnormal increase is more significant. AST and ALT levels may be important predictors of MS morbidity, a comprehensive assessment of MS risk factors and the progression of MS.