Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Korea University, Seoul, Korea.
Metabolism. 2013 Sep;62(9):1305-12. doi: 10.1016/j.metabol.2013.04.002. Epub 2013 May 2.
Increased liver enzymes and decreased vitamin D levels are associated with insulin resistance and type 2 diabetes. We examined liver enzymes and vitamin D levels in metabolically healthy but obese (MHO) individuals and compared the values with those of other body size phenotypes in the Korean population.
MATERIALS/METHODS: A total of 16,190 people over the age of 18years were analyzed using data from the Fourth Korean National Health and Nutrition Examination Survey, which is a nationally representative survey. Body size phenotypes were classified into four groups by body mass index (BMI) and number of metabolic syndrome components.
The prevalence of MHO was 14.9% in the entire population and 47.7% in the obese population. In a correlation analysis adjusted for age, sex, and BMI, AST and ALT levels were positively correlated with insulin resistance and cardiometabolic risk factors of the metabolic syndrome, whereas vitamin D level was negatively correlated with these variables. MHO individuals had significantly lower concentrations of AST and ALT compared to metabolically abnormal obese (MAO) subjects, although vitamin D levels were not significantly different. Furthermore, a multiple logistic regression analysis revealed that MHO individuals had lower risk of liver enzyme abnormality compared to MAO after adjusting for potential confounding factors. However, the risk of vitamin D deficiency was not significantly different among groups with different body size phenotypes.
Although both liver enzymes and vitamin D levels are related to insulin resistance and metabolic syndrome, only liver enzymes were independently associated with MHO phenotype.
肝酶升高和维生素 D 水平降低与胰岛素抵抗和 2 型糖尿病有关。我们检查了代谢健康但肥胖(MHO)个体的肝酶和维生素 D 水平,并将这些值与韩国人群中其他体型表型的数值进行了比较。
材料/方法:使用第四次韩国国家健康和营养检查调查的数据,对 18 岁以上的 16190 人进行了分析,该调查是一项具有全国代表性的调查。体型表型按体重指数(BMI)和代谢综合征成分的数量分为四组。
在整个人群中,MHO 的患病率为 14.9%,在肥胖人群中为 47.7%。在调整年龄、性别和 BMI 的相关性分析中,AST 和 ALT 水平与胰岛素抵抗和代谢综合征的心血管代谢危险因素呈正相关,而维生素 D 水平与这些变量呈负相关。与代谢异常肥胖(MAO)患者相比,MHO 个体的 AST 和 ALT 浓度显著降低,尽管维生素 D 水平没有显著差异。此外,多因素逻辑回归分析显示,在调整潜在混杂因素后,MHO 个体的肝酶异常风险低于 MAO。然而,不同体型表型组之间维生素 D 缺乏的风险没有显著差异。
尽管肝酶和维生素 D 水平都与胰岛素抵抗和代谢综合征有关,但只有肝酶与 MHO 表型独立相关。