Simental-Mendía Luis E, Rodríguez-Morán Martha, Gómez-Díaz Rita, Wacher Niels H, Rodríguez-Hernández Heriberto, Guerrero-Romero Fernando
aBiomedical Research Unit, Mexican Social Security Institute, Durango bMedical Research Unit of Clinical Epidemiology, Specialty Hospital, National Medical Center Century XXI, Mexican Social Security Institute, Mexico City cFaculty of Medicine and Nutrition, Juarez University of Durango State, Durango, Mexico.
Eur J Gastroenterol Hepatol. 2017 Apr;29(4):435-440. doi: 10.1097/MEG.0000000000000811.
The aim of this study is to determine whether insulin resistance is associated with elevation of transaminases levels and aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio in normal-weight healthy young adults.
Apparently healthy nonpregnant women and men, aged 18-23 years, were enrolled in a cross-sectional study. According to the homeostasis model assessment of insulin resistance, the participants were allocated into groups of patients with (>2.5) and without (≤2.5) insulin resistance. Normal weight was defined by BMI of at least 18.5 and less than 25.0 kg/m. A multiple logistic regression analysis was carried out to determine the association between insulin resistance and elevated transaminases and AST/ALT ratio of 1 or less.
A total of 1732 young adults were enrolled and allocated into groups with (n=287) and without (n=1445) insulin resistance. The prevalence of insulin resistance was 16.6% in the overall population. The multivariate logistic regression analysis adjusted by age, sex, waist circumference, and BMI indicated that the odds ratio (OR) between insulin resistance and elevated ALT concentrations is 1.65 [95% confidence interval (CI): 1.04-2.62, P=0.03], for AST/ALT ratio lower than 1 OR is 1.69 (95% CI: 1.27-2.26, P<0.001), and for elevated AST levels OR is 1.31 (95% CI: 0.71-2.43, P=0.377).
The results of the present study suggest that insulin resistance is significantly associated with elevated ALT levels and AST/ALT ratio of lower than 1, but not with elevated AST levels.
本研究旨在确定在体重正常的健康年轻成年人中，胰岛素抵抗是否与转氨酶水平升高及天冬氨酸转氨酶（AST）/丙氨酸转氨酶（ALT）比值相关。
年龄在18 - 23岁、表面健康的非妊娠女性和男性被纳入一项横断面研究。根据胰岛素抵抗的稳态模型评估，参与者被分为胰岛素抵抗（>2.5）组和无胰岛素抵抗（≤2.5）组。正常体重定义为BMI至少为18.5且小于25.0kg/m²。进行多元逻辑回归分析以确定胰岛素抵抗与转氨酶升高及AST/ALT比值小于或等于1之间的关联。
共纳入1732名年轻成年人，分为有胰岛素抵抗组（n = 287）和无胰岛素抵抗组（n = 1445）。总体人群中胰岛素抵抗的患病率为16.6%。经年龄、性别、腰围和BMI调整的多元逻辑回归分析表明，胰岛素抵抗与ALT浓度升高之间的比值比（OR）为1.65 [95%置信区间（CI）：1.04 - 2.62，P = 0.03]，AST/ALT比值低于1时OR为1.69（95% CI：1.27 - 2.26，P < 0.001），AST水平升高时OR为1.31（95% CI：0.71 - 2.43，P = 0.377）。
本研究结果表明，胰岛素抵抗与ALT水平升高及AST/ALT比值低于1显著相关，但与AST水平升高无关。
