Division of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu, China.
Department of General Practice, West China Hospital of Sichuan University, Chengdu, China.
Postgrad Med J. 2018 Nov;94(1117):641-646. doi: 10.1136/postgradmedj-2018-135644. Epub 2018 Dec 6.
Elevation of hepatic enzymes is associated with insulin resistance, dyslipidaemia and obesity. However, the factors behind elevation of liver enzymes remain unclear. The aim of this study was to compare the role of abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) in relation with serum alanine aminotransferase (ALT) and gamma glutamyltransferase (GGT) in middle-aged Chinese adults. METHODS : We performed a cross-sectional study on 959 adults aged 40-65 without hepatitis. VAT and SAT were measured at the level of L4-L5 by MRI. Pearson correlation and linear regression were performed to assess the association of VAT/SAT with serum ALT and GGT. Logistic regression was used to evaluate the association of VAT and SAT with high ALT (≥40 U/L) and high GGT (≥35 U/L). RESULTS: VAT had higher correlation coefficient with ALT and GGT than SAT. VAT, but not SAT, was associated with ALT (males: β=0.15, p=0.01; females: β=0.17, p=0.02) and GGT (males: β=0.39, p<0.0001) in linear regression. VAT remained to be associated with GGT in males (β=0.33, p=0.0001) when was further adjusted. Logistic regression showed that VAT was associated with elevated GGT (OR=2.218, p=0.043) in males but not in females and no such association was observed for SAT. CONCLUSIONS: Increased VAT, but not SAT, was associated with elevation of hepatic enzymes including ALT and GGT. Moreover, VAT was associated with elevated GGT independent of insulin resistance and subcutaneous fat in males.
肝酶升高与胰岛素抵抗、血脂异常和肥胖有关。然而，肝酶升高的背后因素仍不清楚。本研究旨在比较腹部内脏脂肪组织（VAT）和皮下脂肪组织（SAT）与血清丙氨酸氨基转移酶（ALT）和γ-谷氨酰转移酶（GGT）在中年中国成年人中的关系。
我们对 959 名年龄在 40-65 岁、无肝炎的成年人进行了横断面研究。通过 MRI 在 L4-L5 水平测量 VAT 和 SAT。采用 Pearson 相关和线性回归分析评估 VAT/SAT 与血清 ALT 和 GGT 的关系。采用 logistic 回归评估 VAT 和 SAT 与高 ALT（≥40U/L）和高 GGT（≥35U/L）的关系。
VAT 与 ALT 和 GGT 的相关系数高于 SAT。在线性回归中，VAT 与 ALT（男性：β=0.15，p=0.01；女性：β=0.17，p=0.02）和 GGT（男性：β=0.39，p<0.0001）相关，但 SAT 与 ALT 和 GGT 均不相关。当进一步调整胰岛素抵抗和皮下脂肪时，VAT 仍与男性 GGT 相关（β=0.33，p=0.0001）。Logistic 回归显示，VAT 与男性 GGT 升高相关（OR=2.218，p=0.043），但与女性无关，而 SAT 则没有这种相关性。
增加的 VAT，而不是 SAT，与包括 ALT 和 GGT 在内的肝酶升高有关。此外，VAT 与男性 GGT 升高有关，与胰岛素抵抗和皮下脂肪无关。
