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目的探讨丙氨酸氨基转移酶(ALT)升高的人群(除外已知肝脏疾病)是否存在糖脂代谢异常、胰岛素抵抗(IR)以及胰岛β细胞功能减退。方法按照AIT是否≥40U/L将人群分为ALT正常组和ALT升高组。进行OGTT试验,并测量身高、体重、WC及生化指标,计算IR指数(HOMA-IR)和1相Stumvoll指数。结果 ALT升高组BMI、WC、SBP、DBP、尿酸(UA)、TC、TG、LDL-C、PG以及HOMA-IR明显高于ALT正常组,而HDL-C和1相Stumvoll指数明显低于ALT正常组(P<0.01)。部分相关分析结果提示血清ALT与SBP、TC、TG、LDL-C、FPG以及HOMA-IR呈明显的正相关,而与HDL-C和1相Stumvoll指数呈明显的负相关。BMI、TG、LDL-C、HDL-C、ALT以及WC是HOMA-IR独立的影响因子。结论在排除其他肝病的影响因素后,血清ALT升高的人群中可能已经存在明显的IR、血压升高和糖脂代谢异常。
Objective To investigate whether there is abnormal glucose and lipid metabolism, insulin resistance (IR) and islet β-cell dysfunction in people with elevated alanine aminotransferase (ALT), except for known liver diseases. Methods According to whether AIT≥40U / L, the population was divided into normal ALT group and ALT elevated group. The OGTT test was performed and the height, weight, WC and biochemical indexes were measured. The HOMA-IR and 1-phase Stumvoll index were calculated. Results The levels of BMI, WC, SBP, DBP, UA, TC, TG, LDL-C, PG and HOMA-IR in ALT group were significantly higher than those in ALT group ALT normal group (P <0.01). Partial correlation analysis showed that there was a significant positive correlation between serum ALT and SBP, TC, TG, LDL-C, FPG and HOMA-IR, but negatively correlated with HDL-C and Stumvoll index. BMI, TG, LDL-C, HDL-C, ALT and WC were the independent influential factors of HOMA-IR. Conclusion After excluding the influencing factors of other liver diseases, there may be obvious IR, elevated blood pressure and abnormal glucose and lipid metabolism in people with elevated serum ALT.