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目的探讨慢性乙型肝炎(CHB)患者谷胺酰转肽酶(GGT)对代谢的影响。方法分别根据丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)以及GGT水平分组,分析110例CHB患者不同ALT、AST和GGT水平组间代谢指标水平的差异。结果 GGT<1.5倍ULN组患者各项指标异常情况少见,与2~3倍ULN及>3倍ULN组比较,1.5~2倍ULN组患者稳态模型胰岛素抵抗指数(HOMA-IR)、空腹血糖(FPG)及有脂肪肝的比例均显著高于前两组患者(F=6.631、13.839、3.399,P均<0.001),而高密度脂蛋白胆固醇(HDL-c)(1.07 mmol/L)显著低于前两组(χ~2=18.723、P=0.021),虽然HOMA-β(20.34 mIU/mmol)略低于前两组,但差异无统计学意义(F=2.679、P=0.051)。不同ALT、AST水平组间各代谢指标差异均无统计学意义(P均>0.05)。结论慢性乙型肝炎GGT<1.5倍ULN患者代谢异常少见,GGT为1.5~2倍ULN患者胰岛素抵抗、HOMA-β减退、糖脂代谢异常以及肝脂肪化均最为显著,随着GGT继续升高患者代谢异常程度反而减轻。
Objective To investigate the effect of glutamyl transpeptidase (GGT) on metabolism in patients with chronic hepatitis B (CHB). Methods According to the levels of ALT, AST and GGT, the differences of the metabolic indexes of ALT, AST and GGT in 110 CHB patients were analyzed. Results The GGT <1.5-fold ULN group was significantly lower than those in the ULN group. Compared with 2 to 3 times ULN and> 3 times ULN group, the steady-state model of insulin resistance index (HOMA-IR), fasting blood glucose (FPG) and fatty liver were significantly higher than those in the former two groups (F = 6.631,13.839,3.399, P <0.001), while high density lipoprotein cholesterol (HDL-c) was 1.07 mmol / L (Χ ~ 2 = 18.723, P = 0.021). Although HOMA-β (20.34 mIU / mmol) was slightly lower than the first two groups, the difference was not statistically significant (F = 2.679, P = 0.051). There was no significant difference in each metabolic index between different ALT and AST levels (all P> 0.05). CONCLUSIONS: Patients with chronic hepatitis B with GGT <1.5 times ULN have rare metabolic abnormalities. Patients with ULG with 1.5 or 2 times GGT have the highest risk of insulin resistance, HOMA-β, dyslipidemia and hepatic steatosis. As GGT continues to rise Instead, the degree of metabolic abnormalities reduced.