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血清丙氨酸氨基转移酶的纵向增量增加了代谢综合征的发病风险:来自中国的大型队列人群研究。

The longitudinal increments of serum alanine aminotransferase increased the incidence risk of metabolic syndrome: A large cohort population in China.

机构信息

Department of Health Statistics, School of Public Health, Dalian Medical University, Dalian, Liaoning, China; The Centers for Disease Control and Prevention of Molidawa Daur Autonomous Banner, Hulun Buir, Inner Mongolia, China.

Department of Health Statistics, School of Public Health, Dalian Medical University, Dalian, Liaoning, China.

出版信息

Clin Chim Acta. 2019 Jan;488:242-247. doi: 10.1016/j.cca.2018.10.033. Epub 2018 Oct 28.

Abstract

BACKGROUND

Although alanine aminotransferase (ALT) is well known to be associated with metabolic syndrome (MetS), prospective data on longitudinal increments in ALT activities and incident cases of MetS are limited. We analyzed the impact of longitudinal increments of ALT on MetS based on a health check-up population in China.

METHODS

A total of 4491 subjects free of MetS who completed at least two annual health examinations during March 2010 to April 2016 were enrolled in this cohort study. The MetS was defined according to the Joint Interim Statement criteria 2009. The RRs of incident MetS were estimated by using the Cox model and the Joint model in R software.

RESULTS

The cumulative incidence of MetS was 18.55% during the 7 years of follow-up. In the Cox model, the estimated RR of developing MetS was 1.751 (95% CI =1.532-2.000) for 1 unit augmented in LNALT-0 level. In the Joint model, the estimated RR of developing MetS was 3.626 (95% CI = 2.721-4.831) for 1 unit augmented in LNALT activity longitudinally.

CONCLUSIONS

The longitudinal increment of individuals' ALT activity over time increased the incidence risk of MetS and the effects generated by longitudinal increments of ALT on MetS was higher than that generated by baseline ALT.

摘要

背景

尽管丙氨酸氨基转移酶(ALT)与代谢综合征(MetS)密切相关,但关于 ALT 活性的纵向增量与 MetS 发病病例的前瞻性数据有限。我们根据中国的健康检查人群分析了 ALT 纵向增量对 MetS 的影响。

方法

这项队列研究共纳入了 4491 名在 2010 年 3 月至 2016 年 4 月期间至少完成了两次年度健康检查且无 MetS 的受试者。MetS 根据 2009 年联合临时声明标准进行定义。使用 R 软件中的 Cox 模型和联合模型估计了发生 MetS 的风险比(RR)。

结果

在 7 年的随访期间,MetS 的累积发病率为 18.55%。在 Cox 模型中,LNALT-0 水平增加 1 个单位时,发生 MetS 的 RR 估计值为 1.751(95%CI=1.532-2.000)。在联合模型中,LNALT 活性纵向增加 1 个单位时,发生 MetS 的 RR 估计值为 3.626(95%CI=2.721-4.831)。

结论

个体 ALT 活性随时间的纵向增量增加了 MetS 的发病风险,并且 ALT 纵向增量对 MetS 的影响高于基线 ALT 的影响。

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