Nikniaz Leila, Nikniaz Zeinab, Tabrizi Jafar Sadegh, Sadeghi-Bazargani Homayoun, Farahbakhsh Mostafa
Tabriz Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Liver and Gastrointestinal Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Clin Res Hepatol Gastroenterol. 2018 Feb;42(1):92-98. doi: 10.1016/j.clinre.2017.06.006. Epub 2017 Aug 31.
Considering the clear association between metabolic syndrome and future cardiovascular disease, early detection of metabolic syndrome is important. This study was conducted to assess the correlation between metabolic syndrome components and within-normal-range of liver enzymes in Iranian adults.
This cross-sectional study was comprised of 700 Iranian adults in the districts of East Azerbaijan-Iran in 2015. The levels of lipid profile and glucose were measured by enzymatic colorimetric methods. Weight, height, waist circumferences were measured with standard protocols. Aspartate aminotransferase (AST) and Alanine aminotransferase (ALT) were assessed using the ultraviolet method. The Pearson correlation and Logistic regression were used to for statistical analysis.
With increasing the number of metabolic abnormalities, the mean ALT level was increased significantly (P=0.04). In women, the increase in AST and ALT with increasing the number of metabolic abnormalities was statistically significant (P=0.01; P<0.001). In men, ALT level had significantly positive correlation with waist circumference (r=0.14, P<0.05), serum TG (r=0.16, P<0.05) and fasting plasma glucose (r=0.17, P<0.01). In women, there was a significant correlation between AST level and serum TG (r=0.15, P<0.05). A significant positive and negative correlation were found respectively between serum ALT and AST/ALT ratio and waist circumference, serum TG and fasting blood glucose. Women in the 4th quartile of ALT were 4.43 fold at an increased risk for metabolic syndrome outcome when compared to those in the first quartile [OR (95% CI): 4.43 (1.69, 11.63)]. In women, with increasing the quartiles of ALT within normal limits, the percent of participants with metabolic syndrome also increased significantly (P=0.04).
Based on the results, the use of ALT and AST:ALT ratio as continuous biomarkers for early signaling of dysmetabolism especially in women could be encouraged.
鉴于代谢综合征与未来心血管疾病之间存在明确关联，早期发现代谢综合征很重要。本研究旨在评估伊朗成年人代谢综合征各组分与肝酶在正常范围内的相关性。
这项横断面研究于2015年在伊朗东阿塞拜疆地区的700名成年人中进行。采用酶比色法测量血脂和血糖水平。按照标准方案测量体重、身高和腰围。使用紫外法评估天冬氨酸转氨酶（AST）和丙氨酸转氨酶（ALT）。采用Pearson相关性分析和逻辑回归进行统计分析。
随着代谢异常数量的增加，ALT平均水平显著升高（P = 0.04）。在女性中，随着代谢异常数量的增加，AST和ALT升高具有统计学意义（P = 0.01；P < 0.001）。在男性中，ALT水平与腰围（r = 0.14，P < 0.05）、血清甘油三酯（r = 0.16，P < 0.05）和空腹血糖（r = 0.17，P < 0.01）呈显著正相关。在女性中，AST水平与血清甘油三酯之间存在显著相关性（r = 0.15，P < 0.05）。血清ALT与AST/ALT比值分别与腰围、血清甘油三酯和空腹血糖呈显著正相关和负相关。ALT处于第四四分位数的女性发生代谢综合征结局的风险是第一四分位数女性的4.43倍[比值比（95%置信区间）：4.43（1.69，11.63）]。在女性中，随着ALT在正常范围内四分位数的增加，患有代谢综合征的参与者百分比也显著增加（P = 0.04）。
基于这些结果，可鼓励将ALT和AST:ALT比值用作代谢紊乱早期信号的连续生物标志物，尤其是在女性中。
