Bathum L, Petersen H C, Rosholm J U, Hyltoft Petersen P, Vaupel J, Christensen K
Department of Clinical Biochemistry, Odense University Hospital, DK-5000 Odense C, Denmark.
Clin Chem. 2001 Jan;47(1):81-7.
Biochemical liver function tests are widely used in the clinic and are some of the most frequently used tests in screening for diseases in older age groups. The aim of the present study was to estimate the relative importance of genetic and environmental factors to variations in these tests among the elderly.
We conducted a survey among Danish twins, 73-102 years of age, identified in the population-based Danish Twin Registry. Among the 2749 individuals in the study population, an interview was conducted with 79%. From these, a blood sample was collected from 290 same-sex twin pairs, total of 580 subjects, within a 6-month period and analyzed for alanine aminotransferase (ALT), lactate dehydrogenase (LDH), gamma-glutamyltransferase (GGT), bilirubin, and albumin. The interview included questions about alcohol consumption and body mass index (BMI; self-calculated height and weight). Heritability (proportion of the population variance attributable to genetic variation) was estimated using structural-equation analyses before and after correction for alcohol consumption and BMI.
Structural-equation analyses revealed a substantial heritability (35-61%) for the four biochemical liver function tests: ALT, GGT, LDH, and bilirubin. The remaining variation could be attributed to individuals' nonfamilial environments. Adjustment for alcohol consumption and BMI had no influence on the heritability for ALT, GGT, LDH, and bilirubin. For albumin, two models fit equally well before adjustment for alcohol and BMI: a model including additive genetic and nonshared environmental factors (AE), and a model including shared and nonshared environmental factors (CE). After adjustment, the model including shared and nonshared environment was clearly the best fitting model.
For both males and females, the effect of genetic factors on the biochemical liver function tests ALT, GGT, LDH, and bilirubin is substantial and accounts for one-third to two-thirds of the variation among individuals 73-102 years of age. The heritability is equal for males and females and does not change notably after controlling for alcohol consumption and BMI. For albumin, no major impact of genetic factors was found independent of BMI and alcohol consumption. An understanding of the genetic mechanisms underlying biochemical liver function tests among the very old may be of value in the interpretation of these tests in this age group.
生化肝功能检查在临床上广泛应用，是老年人群疾病筛查中最常用的检查项目之一。本研究的目的是评估遗传和环境因素对老年人这些检查结果变异的相对重要性。
我们对丹麦双胞胎登记处中73至102岁的丹麦双胞胎进行了一项调查。在研究人群的2749名个体中，79%接受了访谈。从这些人中，在6个月内收集了290对同性双胞胎的血样，共580名受试者，并对丙氨酸转氨酶（ALT）、乳酸脱氢酶（LDH）、γ-谷氨酰转移酶（GGT）、胆红素和白蛋白进行了分析。访谈包括关于饮酒和体重指数（BMI；自行计算身高和体重）的问题。在对饮酒和BMI进行校正前后，使用结构方程分析估计遗传力（群体方差中可归因于遗传变异的比例）。
结构方程分析显示，四种生化肝功能检查（ALT、GGT、LDH和胆红素）具有显著的遗传力（35 - 61%）。其余变异可归因于个体的非家庭环境。对饮酒和BMI进行校正对ALT、GGT、LDH和胆红素的遗传力没有影响。对于白蛋白，在对饮酒和BMI进行校正之前，两个模型拟合效果相同：一个模型包括加性遗传和非共享环境因素（AE），另一个模型包括共享和非共享环境因素（CE）。校正后，包括共享和非共享环境的模型显然是最佳拟合模型。
对于男性和女性，遗传因素对生化肝功能检查ALT、GGT、LDH和胆红素的影响很大，占73至102岁个体间变异的三分之一至三分之二。男性和女性的遗传力相等，在控制饮酒和BMI后没有明显变化。对于白蛋白，未发现独立于BMI和饮酒的遗传因素的重大影响。了解高龄人群生化肝功能检查背后的遗传机制可能有助于解释该年龄组的这些检查结果。
Zotero 插件