Ma Xiaokun, Wang Qingzhu, Qin Guijun, Zhao Yanyan, Zhang Yinghui, Ma Xiaojun, Li Zhizhen, Wang Zhimin, Ren Gaofei, Bi Yufang, Wang Weiqing, Ning Guang
Department of Endocrinology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China. Email:
Zhonghua Nei Ke Za Zhi. 2014 Mar;53(3):198-201.
To investigate the correlation between serum liver enzymes and onset of type 2 diabetes mellitus (T2DM).
A total of 8 779 individuals subjected to a Zhengzhou community survey were enrolled in the study and were tested for the following serum biochemical parameters, including ALT, AST, γ-glutamyl transferase (GGT), TC, TG and blood glucose. All subjects were divided into four groups (Q1-Q4) according to the quartiles of their liver enzyme levels. Logistic regression was performed to explore the odd ratio (OR) for the onset of T2DM in groups of Q2-Q4 compared with the group of Q1.ROC curve was used to analyze the predictive value of elevated liver enzymes for the onset of T2DM.
When the quartiles were defined by the GGT level, compared with the group of Q1, the OR for the group of Q4 was 4.043 (95%CI 2.759-5.924) in the male and 4.239 (95%CI 3.172-5.664) in the female, which was higher than the OR when the quartiles were defined by the ALT level. In the ROC curve, the AUC of GGT was larger than those of ALT, AST, BMI, waist circumference and TG, with 0.63 for the male and 0.68 for the female.
Serum level of GGT is more closely correlated with the onset of T2MD than the level of ALT or AST. Even the increase of serum GGT within physiological range is a risk factor for the onset of T2DM.
探讨血清肝酶与2型糖尿病（T2DM）发病之间的相关性。
共有8779名接受郑州社区调查的个体纳入本研究，并检测以下血清生化参数，包括谷丙转氨酶（ALT）、谷草转氨酶（AST）、γ-谷氨酰转移酶（GGT）、总胆固醇（TC）、甘油三酯（TG）和血糖。所有受试者根据其肝酶水平的四分位数分为四组（Q1-Q4）。采用Logistic回归分析Q2-Q4组与Q1组相比T2DM发病的比值比（OR）。采用ROC曲线分析肝酶升高对T2DM发病的预测价值。
当以GGT水平定义四分位数时，与Q1组相比，男性Q4组的OR为4.043（95%CI 2.759-5.924），女性为4.239（95%CI 3.172-5.664），高于以ALT水平定义四分位数时的OR。在ROC曲线中，GGT的曲线下面积（AUC）大于ALT、AST、体重指数（BMI）、腰围和TG，男性为0.63，女性为0.68。
血清GGT水平与T2DM发病的相关性比ALT或AST水平更密切。即使血清GGT在生理范围内升高也是T2DM发病的危险因素。
