Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA.
Division of Endocrinology, Diabetes and Hypertension, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Metabolism. 2014 Jun;63(6):773-82. doi: 10.1016/j.metabol.2014.03.008. Epub 2014 Mar 15.
To comparatively evaluate traditional liver tests and fetuin A as predictors of cardiometabolic risk, we studied associations between serum alanine transaminase (ALT), γ-glutamyl transferase (GGT), aspartate aminotransferase (AST) and fetuin-A and anthropometric, metabolic, and cardiovascular parameters cross-sectionally at baseline, and prospectively, after 2-years of follow-up.
616 randomly enrolled young healthy participants in the Cyprus Metabolism Study, including all 93 subjects who participated in the follow-up study 2 years after baseline assessment, were included in this study.
In the cross-sectional study, serum ALT and GGT were strongly correlated with anthropometric, cardiovascular, and metabolic variables, while serum AST was only correlated with waist circumference and waist-to-hip ratio. Fetuin-A was correlated with anthropometric variables, systolic blood pressure (SBP), insulin, and homeostasis model of assessment-insulin resistance (HOMA-IR) in the unadjusted model. In the fully adjusted model, both serum ALT and GGT levels remained positively correlated with total and low-density lipoprotein (LDL) cholesterol. GGT levels also remained correlated with triglycerides. ALT levels remained strongly positively correlated with insulin (r=0.17, p<.0001) and HOMA-IR (r=0.16, p=0.0001). Serum fetuin-A levels were no longer significantly correlated with any variables. Prospectively, ALT and GGT were predictors of anthropometric variables and LDL cholesterol, while baseline levels of AST and fetuin-A were not predictors of any variables at 2-year follow-up.
We confirmed associations of ALT and GGT levels but failed to demonstrate an independent association between fetuin-A and cardiometabolic risk factors in young healthy men. Traditional liver tests (LFTs) are thus better than fetuin-A predictors of metabolic risk factors cross-sectionally and prospectively in young healthy adults.
为了比较传统肝脏测试和胎球蛋白 A 作为心血管代谢风险预测因子的效果，我们研究了血清丙氨酸转氨酶（ALT）、γ-谷氨酰转移酶（GGT）、天冬氨酸转氨酶（AST）和胎球蛋白 A 与人体测量、代谢和心血管参数之间的关联，这些关联是在基线时进行的横断面研究，在随访 2 年后进行的前瞻性研究中也进行了评估。
616 名随机入选的塞浦路斯代谢研究中的年轻健康参与者，包括所有在基线评估 2 年后参加随访研究的 93 名受试者，均纳入本研究。
在横断面研究中，血清 ALT 和 GGT 与人体测量、心血管和代谢变量密切相关，而血清 AST 仅与腰围和腰臀比相关。胎球蛋白 A 与人体测量变量、收缩压（SBP）、胰岛素和稳态模型评估胰岛素抵抗（HOMA-IR）在未调整模型中相关。在完全调整模型中，血清 ALT 和 GGT 水平与总胆固醇和低密度脂蛋白（LDL）胆固醇仍呈正相关。GGT 水平也与甘油三酯相关。ALT 水平与胰岛素（r=0.17，p<.0001）和 HOMA-IR（r=0.16，p=0.0001）仍呈强烈正相关。血清胎球蛋白 A 水平与任何变量均不再显著相关。前瞻性研究显示，ALT 和 GGT 是人体测量变量和 LDL 胆固醇的预测因子，而基线 AST 和胎球蛋白 A 水平不能预测 2 年后的任何变量。
我们证实了 ALT 和 GGT 水平的相关性，但未能证明胎球蛋白 A 与年轻健康男性的心血管代谢危险因素之间存在独立相关性。因此，在年轻健康成年人中，传统肝脏测试（LFTs）在横断面和前瞻性研究中是比胎球蛋白 A 更好的代谢危险因素预测因子。
