Fatih University Medical School, Department of Internal Medicine, Ankara, Turkey.
Indian J Med Res. 2010 Jul;132:56-61.
BACKGROUND & OBJECTIVES: The aim of this study is to know if the liver function tests (LFT), especially gamma glutamyl transferase (GGT), have a predictive value in diagnosis of metabolic syndrome (MS).
A cross-sectional, single-center study was carried out with 908 subjects. Four hundred and forty two of these subjects were diagnosed with MS with IDF criteria; while other 466 were sex and age matched healthy control subjects. Blood pressure, liver function tests, fasting blood glucose levels and lipid profile of the subjects were recorded.
The mean values of alanine amino transferase (ALT), aspartate aminotransferase (AST) and GGT levels were statistically significantly higher in MS group. The mean values of liver enzymes, for female/ male subjects in MS group, AST; ALT and GGT respectively, were; 20.5/19.7 U/l; 25.9/28.5 U/l; 35.9/42.1 U/l. When the sample is divided into quartiles of the GGT levels, increase in GGT is positively correlated with increased MS prevalence. In ROC analysis GGT is as strongly associated with the IDF diagnostic components as is each individual IDF component, except elevated systolic blood pressure. In covariance analysis, there was significant relationship between elevated GGT levels and MS presence after adjustment for age, sex and MS diagnostic criteria; but not AST and ALT levels. In multivariance analysis, in MS group, a high GGT was positively associated with CVD prevalance (odds ratio: 2.011, 95% CI 1.10-4.57) compared to low GGT group independent of age, sex and smoking habits.
INTERPRETATION & CONCLUSIONS: Elevated liver enzymes, although in normal ranges, especially at upper quartiles, play a central role in early diagnosis of fat overflow to the liver. Regarding the availability and simplicity of these tests in routine clinical practice, they, especially GGT, have potential to be considered in algorithms for metabolic syndrome.
本研究旨在探讨肝功能检查（LFT），特别是γ-谷氨酰转移酶（GGT），对代谢综合征（MS）诊断的预测价值。
本研究为一项横断面、单中心研究，共纳入 908 例受试者。其中 442 例受试者符合 IDF 标准，诊断为 MS；466 例为性别和年龄匹配的健康对照者。记录受试者的血压、肝功能检查、空腹血糖水平和血脂谱。
MS 组的丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）和 GGT 水平的平均值均显著升高。MS 组女性/男性受试者的肝酶平均值分别为：AST：20.5/19.7 U/l；ALT：25.9/28.5 U/l；GGT：35.9/42.1 U/l。当将样本按 GGT 水平四等分后，GGT 水平升高与 MS 患病率增加呈正相关。ROC 分析显示，GGT 与 IDF 诊断标准各个组成部分一样，与 MS 的相关性与每个 IDF 组成部分一样强，除了收缩压升高。在协方差分析中，在校正年龄、性别和 MS 诊断标准后，GGT 水平升高与 MS 存在显著相关；但 AST 和 ALT 水平与 MS 无关。在多元分析中，与低 GGT 组相比，MS 组中 GGT 升高与 CVD 患病率呈正相关（比值比：2.011，95%CI 1.10-4.57），独立于年龄、性别和吸烟习惯。
即使在正常范围内，尤其是在上四分位值时，升高的肝酶，特别是γ-谷氨酰转移酶（GGT），在肝脏脂肪溢出的早期诊断中起着核心作用。鉴于这些检测在常规临床实践中的可用性和简单性，它们，特别是 GGT，有可能被考虑纳入代谢综合征的算法中。
