Jo Sook-Kyoung, Lee Won-Young, Rhee Eun-Jung, Won Jong-Chul, Jung Chan-Hee, Park Cheol-Young, Oh Ki-Won, Park Sung-Woo, Kim Sun-Woo
Department of Endocrinology and Rheumatology, SAM Anyang Hospital, Anyang, Republic of Korea.
Clin Chim Acta. 2009 May;403(1-2):234-40. doi: 10.1016/j.cca.2009.03.035. Epub 2009 Mar 28.
Recent studies suggest the role of liver enzymes, such as serum gamma-glutamyl transferase (GGT) and alanine aminotransferase (ALT) as the predictor for future development of metabolic syndrome (MetS), diabetes and cardiovascular disease in epidemiologic studies. We hypothesized that serum concentrations of GGT and ALT are associated with the development of MetS, according to newly recommended criteria from International Diabetes Federation (IDF) and American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) definition in Koreans.
A total of 15,250 males (mean 38 y) and 6280 females (mean 41 y) who visited the Health Promotion Center at Kangbuk Samsung Hospital for medical check-up in 2002, were followed-up after 4 y. We analyzed the development of MetS in their follow-up data in 2006.
When the subjects were divided into quartiles by the baseline GGT levels, the odds ratio for the MetS defined by both criteria across the quartile groups increased as the quartile groups increased in both gender groups. This association remained significant even after adjustment for confounding factors, such as, age, alcohol intake, smoking status, physical activity, ALT, fasting insulin and HOMA-IR. Serum ALT concentration also showed significantly positive correlation with development of MetS defined by the two criteria even after adjustment for age and GGT in both gender groups. In addition, risk for the individual MetS components increased as the baseline GGT concentrations increased, except low high-density lipoprotein cholesterol (HDL-C) in female group. In receiver operating characteristic (ROC) curves, the area under the curves (AUC) of GGT and ALT to predict future MetS by both criteria was larger than the AUCs of blood pressure, fasting glucose and HDL-C.
In this large prospective study in Koreans, high baseline GGT and ALT concentrations predicted future development of MetS defined by IDF and AHA/NHLBI criteria after 4 y of follow-up.
近期研究表明，在流行病学研究中，血清γ-谷氨酰转移酶（GGT）和丙氨酸氨基转移酶（ALT）等肝酶可作为代谢综合征（MetS）、糖尿病和心血管疾病未来发展的预测指标。我们推测，根据国际糖尿病联盟（IDF）和美国心脏协会/美国国立心肺血液研究所（AHA/NHLBI）对韩国人的新推荐标准，血清GGT和ALT浓度与MetS的发生有关。
2002年到江北三星医院健康促进中心进行体检的15250名男性（平均38岁）和6280名女性（平均41岁）在4年后接受随访。我们分析了他们2006年随访数据中MetS的发生情况。
当根据基线GGT水平将受试者分为四分位数时，两个性别组中四分位数组的MetS发生的比值比均随着四分位数组的升高而增加。即使在调整了年龄、酒精摄入量、吸烟状况、身体活动、ALT、空腹胰岛素和HOMA-IR等混杂因素后，这种关联仍然显著。在两个性别组中，即使在调整了年龄和GGT后，血清ALT浓度与两种标准定义的MetS发生也显示出显著的正相关。此外，除女性组的低高密度脂蛋白胆固醇（HDL-C）外，随着基线GGT浓度的增加，各MetS组分的风险也增加。在受试者工作特征（ROC）曲线中，GGT和ALT预测未来两种标准定义的MetS的曲线下面积（AUC）大于血压、空腹血糖和HDL-C的AUC。
在这项针对韩国人的大型前瞻性研究中，高基线GGT和ALT浓度可预测4年随访后IDF和AHA/NHLBI标准定义的MetS的未来发生情况。
