Department of Preventive Medicine, School of Medicine, Kyung Hee University.
Diabet Med. 2014 Apr;31(4):455-61. doi: 10.1111/dme.12315. Epub 2013 Oct 9.
In recent years, γ-glutamyltransferase has emerged as a predictor of cardiovascular disease, Type 2 diabetes mellitus, the metabolic syndrome and hypertension. However, it is not yet certain whether γ-glutamyltransferase is a predictor for insulin resistance. The aim of this study was to examine the longitudinal association between baseline γ-glutamyltransferase level and the development of insulin resistance in Korean men.
We performed a prospective cohort study, involving 22 931 healthy Korean men without baseline insulin resistance (homeostasis model assessment of insulin resistance, HOMA-IR < 2.7) for 5 years. We checked the HOMA-IR serially to monitor the development of insulin resistance (incidence of HOMA-IR ≥ 2.7). A Cox proportional hazards model was used to determine hazard ratios for insulin resistance by quartile groups of baseline serum γ-glutamyltransferase levels.
During 81 208.6 person-years of follow-up, 3856 (16.8%) cases of insulin resistance developed between 2006 and 2010. After adjusting for multiple covariates, including baseline HOMA-IR, the hazard ratios (95% CI) for incident insulin resistance comparing the second to the fourth quartile of baseline serum γ-glutamyltransferase levels with the first quartile were 1.19 (1.06-1.33), 1.38 (1.23-1.53) and 1.58 (1.41-1.77), respectively (P for trend < 0.001).
Our findings show that serum γ-glutamyltransferase level could be a predictor of the development of insulin resistance in Korean men.
近年来,γ-谷氨酰转移酶已成为心血管疾病、2 型糖尿病、代谢综合征和高血压的预测因子。然而,γ-谷氨酰转移酶是否是胰岛素抵抗的预测因子尚不确定。本研究旨在探讨韩国男性人群中基线 γ-谷氨酰转移酶水平与胰岛素抵抗发展之间的纵向关联。
我们进行了一项前瞻性队列研究,纳入了 22931 名基线无胰岛素抵抗(稳态模型评估的胰岛素抵抗指数,HOMA-IR<2.7)的健康韩国男性,随访时间为 5 年。我们连续检查 HOMA-IR,以监测胰岛素抵抗的发展(HOMA-IR≥2.7 的发生率)。采用 Cox 比例风险模型按基线血清 γ-谷氨酰转移酶四分位组确定胰岛素抵抗的风险比。
在 81208.6 人年的随访期间,2006 年至 2010 年期间发生了 3856 例(16.8%)胰岛素抵抗病例。在校正了包括基线 HOMA-IR 在内的多个协变量后,与第 1 四分位组相比,第 2 至第 4 四分位组基线血清 γ-谷氨酰转移酶水平的胰岛素抵抗发生风险比(95%CI)分别为 1.19(1.06-1.33)、1.38(1.23-1.53)和 1.58(1.41-1.77)(趋势 P<0.001)。
我们的研究结果表明,血清 γ-谷氨酰转移酶水平可能是韩国男性人群中胰岛素抵抗发展的预测因子。