Liu Meng, Yan Hong-mei, Gao Xin, Gao Jian
Department of Endocrinology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
Zhonghua Yi Xue Za Zhi. 2007 Jan 23;87(4):253-5.
To investigate the changes of liver enzymes in the patients with nonalcoholic fatty liver disease (NAFLD) and to analyze the association between liver enzymes and metabolic syndrome (MS).
318 non-diabetic subjects with NAFLD underwent anthropometry (height, weight, waist and hip circumference, and blood pressure), laboratory tests, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), gamma-glutamyltransferase (GGT), serum lipid, fasting and 2 hour plasma glucose, and insulin after 75 g glucose load, and abdominal ultrasonography. Metabolic syndrome was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III criteria.
174 of the 318 NAFLD patients (54.7%) showed 1 to more abnormal liver enzymes. 123 of the 318 NAFLD patients (38.7%) were diagnosed as with MS, among which 48.8% of those with abnormal liver enzymes were diagnosed as with MS, a percentage significantly higher than that of those without normal liver enzyme (28.6%, P < 0.001). The levels of the 4 liver enzymes were all higher in the group with MS than in the group without MS (all P < 0.05). With the increase of the number of elevated MS components the serum levels of ALT, AST, and GGT were elevated accordingly. The risk of abnormality of liver enzyme levels significantly increased with the number of MS components after adjustment for age and sex [OR (95% CI): ALT 1.78 (1.37 approximately 2.32), AST 1.65 (1.19 approximately 2.29), GGT 1.81 (1.35 approximately 2.43)].
Most patients with NAFLD have abnormal liver enzymes, and the percentage of MS is higher in the abnormal liver enzyme group. The risk of abnormality of liver enzyme levels significantly increases with the number of MS components which suggested the components of MS might be the risk factor of increase of liver enzymes' levels.
探讨非酒精性脂肪性肝病(NAFLD)患者肝酶的变化,并分析肝酶与代谢综合征(MS)之间的关联。
对318例非糖尿病NAFLD患者进行人体测量(身高、体重、腰围和臀围以及血压)、实验室检查,包括丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、碱性磷酸酶(ALP)、γ-谷氨酰转移酶(GGT)、血脂、空腹及75g葡萄糖负荷后2小时血浆葡萄糖和胰岛素,以及腹部超声检查。根据美国国家胆固醇教育计划成人治疗小组第三次报告标准诊断代谢综合征。
318例NAFLD患者中,174例(54.7%)出现1项或多项肝酶异常。318例NAFLD患者中,123例(38.7%)被诊断为患有MS,其中肝酶异常者中48.8%被诊断为患有MS,该百分比显著高于肝酶正常者(28.6%,P<0.001)。MS组的4种肝酶水平均高于无MS组(均P<0.05)。随着MS升高组分数量的增加,血清ALT、AST和GGT水平相应升高。在调整年龄和性别后,肝酶水平异常的风险随着MS组分数量的增加而显著增加[比值比(95%可信区间):ALT为1.78(1.37至2.32),AST为1.65(1.19至2.29),GGT为1.81(1.35至2.43)]。
大多数NAFLD患者肝酶异常,肝酶异常组中MS患病率更高。肝酶水平异常的风险随着MS组分数量的增加而显著增加,提示MS的组分可能是肝酶水平升高的危险因素。