Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 4770 Buford Highway, Mail Stop K67, Atlanta, GA 30341, USA.
J Behav Med. 2012 Apr;35(2):200-10. doi: 10.1007/s10865-011-9353-5. Epub 2011 May 28.
The aim of this cross-sectional study was to present nationally representative findings on the co-occurrence of obesity and specific patterns of alcohol use associated with elevated serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyltransferase (GGT) among adults in the United States. We analyzed data from 8,373 adults aged ≥ 20 years who participated in the 2005-2008 National Health and Nutrition Examination Survey. We produced prevalence ratios by using the co-occurrence of obesity (i.e., body mass index ≥ 30.0 kg/m(2) or waist circumference ≥ 102 cm in men and ≥ 88 cm in women) and specific patterns of alcohol use (i.e., non-drinkers, non-excessive drinkers, and excessive drinkers) as a predictor; elevations in serum ALT, AST, and GGT were used as an outcome variable while adjusting for covariates in multivariate regression models. Approximately 34.7% of adult men and 38.6% of adult women in the United States had co-occurrence of obesity and any alcohol use, including 16.4% of men and 9.8% of women who had co-occurrence of obesity and excessive drinking during 2005-2008. When compared to male non-drinkers without obesity after multivariate adjustment, male excessive drinkers with obesity were 3.08 (95% CI: 1.80-5.28), 2.42 (95% CI: 1.80-3.26), and 3.15 (95% CI: 1.82-5.46) times more likely to exhibit elevated serum ALT, AST, and GGT, respectively. Similarly, when compared to female non-drinkers without obesity, female excessive drinkers with obesity were 2.36 (95% CI: 1.38-4.04), 3.27 (95% CI: 1.85-5.78), and 3.43 (95% CI: 2.19-5.40) times more likely to have elevated serum ALT, AST, and GGT, respectively. The co-occurrence of obesity and excessive drinking may place adults at an increased risk for potential liver injury. Our study findings provide support for evidence-based clinical and population-based interventions that integrate health behavior change among adults who have these co-occurring risk factors.
本横断面研究旨在呈现美国成年人中肥胖与特定饮酒模式同时存在与血清丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）和γ-谷氨酰转移酶（GGT）升高相关的全国代表性发现。我们分析了 2005-2008 年全国健康和营养调查中 8373 名年龄≥20 岁的成年人的数据。我们使用肥胖（即 BMI≥30.0kg/m²或男性腰围≥102cm，女性腰围≥88cm）和特定饮酒模式（即非饮酒者、非过量饮酒者和过量饮酒者）同时存在作为预测因素，血清 ALT、AST 和 GGT 升高作为因变量，在多变量回归模型中调整协变量后得出患病率比。美国约有 34.7%的成年男性和 38.6%的成年女性同时存在肥胖和任何饮酒，其中 16.4%的男性和 9.8%的女性在 2005-2008 年同时存在肥胖和过量饮酒。经多变量调整后，与非肥胖的男性非饮酒者相比，肥胖的男性过量饮酒者血清 ALT、AST 和 GGT 升高的可能性分别高出 3.08 倍（95%CI：1.80-5.28）、2.42 倍（95%CI：1.80-3.26）和 3.15 倍（95%CI：1.82-5.46）。同样，与非肥胖的女性非饮酒者相比，肥胖的女性过量饮酒者血清 ALT、AST 和 GGT 升高的可能性分别高出 2.36 倍（95%CI：1.38-4.04）、3.27 倍（95%CI：1.85-5.78）和 3.43 倍（95%CI：2.19-5.40）。肥胖与过量饮酒同时存在可能使成年人面临潜在肝损伤的风险增加。我们的研究结果为针对具有这些共同危险因素的成年人的循证临床和人群干预措施提供了支持。
