Belan Matea, Pelletier Chloé, Baillargeon Jean-Patrice
Division of Endocrinology, Department of Medicine, Université de Sherbrooke , Sherbrooke, Canada .
Metab Syndr Relat Disord. 2017 Apr;15(3):145-152. doi: 10.1089/met.2016.0119. Epub 2017 Feb 22.
Several studies have reported higher levels of Alanine aminotransferase (ALT) in women with polycystic ovary syndrome (PCOS) compared with control subjects. Plasma ALT levels are considered a marker of hepatic lipotoxicity because of their significant associations with different hepatic metabolic dysfunctions, such as hepatic steatosis and hepatic insulin resistance.
Retrospective chart review aiming to assess, in PCOS women, the relationship between ALT levels and measures of lipotoxicity consequences that are available clinically, both during fasting and using the oral glucose tolerance test.
Women (n = 132) with PCOS, were in average 27.9 years of age, with a mean body mass index of 34.1 kg/m and 49% had a metabolic syndrome (MetS). ALT levels were significantly correlated with homeostatic model assessment for insulin resistance (r = 0.42, P < 0.001), HDL-C (r = -0.31, P < 0.001), Matsuda index (-0.45, P < 0.001), insulin secretion-sensitivity index-2 (-0.26, P = 0.043), and free testosterone (0.38, P < 0.001), but not with fasting glucose and triglyceride levels. ALT cutoff ≥24 IU/L was associated with all these parameters, including fasting glucose (P = 0.021) and triglyceride levels (P = 0.041), and detected more women with the MetS (59.2% vs. 36.1%, P = 0.008) and whole-body insulin resistance (Matsuda index <12.3 L·10/mmol, 85.3% vs. 51.9%, P = 0.004).
Plasma ALT levels seem to be a strong predictor not only of liver lipotoxicity but also of systemic lipotoxic consequences and hyperandrogenemia in women with PCOS. Although it requires validation in another study, an ALT cutoff of ≥24 IU/L may help clinicians identify women with increased metabolic risks.
多项研究报告称，与对照组相比，多囊卵巢综合征（PCOS）女性的丙氨酸氨基转移酶（ALT）水平更高。血浆ALT水平被认为是肝脏脂肪毒性的标志物，因为它们与不同的肝脏代谢功能障碍，如肝脂肪变性和肝脏胰岛素抵抗，存在显著关联。
进行回顾性病历审查，旨在评估PCOS女性在空腹和口服葡萄糖耐量试验期间ALT水平与临床上可用的脂肪毒性后果指标之间的关系。
132名PCOS女性的平均年龄为27.9岁，平均体重指数为34.1kg/m，49%患有代谢综合征（MetS）。ALT水平与胰岛素抵抗的稳态模型评估（r = 0.42，P < 0.001）、高密度脂蛋白胆固醇（HDL-C，r = -0.31，P < 0.001）、松田指数（-0.45，P < 0.001）、胰岛素分泌-敏感性指数-2（-0.26，P = 0.043）和游离睾酮（0.38，P < 0.001）显著相关，但与空腹血糖和甘油三酯水平无关。ALT临界值≥24 IU/L与所有这些参数相关，包括空腹血糖（P = 0.021）和甘油三酯水平（P = 0.041），并且检测出更多患有MetS的女性（59.2%对36.1%，P = 0.008）和全身胰岛素抵抗（松田指数<12.3 L·10/mmol，85.3%对51.9%，P = 0.004）。
血浆ALT水平似乎不仅是PCOS女性肝脏脂肪毒性的有力预测指标，也是全身脂肪毒性后果和高雄激素血症的有力预测指标。尽管需要在另一项研究中进行验证，但ALT临界值≥24 IU/L可能有助于临床医生识别代谢风险增加的女性。
