Li Jun, Hua Simin, Chen Guo-Chong, Strizich Garrett, Kuniholm Mark H, Shan Zhilei, Talavera Gregory A, Castañeda Sheila F, Gellman Marc D, Cai Jianwen, Cotler Scott J, Zhang Xuehong, Hu Frank B, Kaplan Robert, Isasi Carmen R, Qi Qibin
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Liver Int. 2020 Aug;40(8):1883-1894. doi: 10.1111/liv.14514. Epub 2020 May 25.
BACKGROUND & AIMS: Sedentariness and physical inactiveness are associated with deleterious health outcomes, but their associations with liver enzyme elevations remain uncertain.
In 10 385 US Hispanics/Latinos from the Hispanic Community Health Study/Study of Latinos, we examined associations of sedentary time and moderate-to-vigorous physical activity (MVPA) measured by accelerometers with liver enzyme elevations. Elevated alanine aminotransferase (ALT), aspartate aminotransferase and γ-glutamyltransferase (GGT) were defined as the highest gender-specific deciles. Prevalence ratios (PRs) and 95% confidence intervals (CIs) were calculated using weighted Poisson regressions.
After adjusting for demographical/socioeconomic factors and MVPA, increasing quartiles of sedentary time were associated with a higher prevalence of elevated ALT (PRs [95% CI] = 1.0, 1.17 [0.92-1.47], 1.21 [0.96, 1.53] and 1.51 [1.13-2.02]; P-trend = .007) and elevated GGT (PRs [95% CI] = 1.0, 1.06 [0.82-1.36], 1.35 [1.06-1.73] and 1.66 [1.27-2.16]; P-trend = .0001). These associations were attenuated but remained significant after further adjustment for cardiometabolic traits including body-mass index, waist-hip-ratio, lipids and homeostatic model assessment of insulin resistance. In contrast, increasing quartiles of MVPA were associated with a lower prevalence of elevated ALT (PRs [95% CI] =1.0, 0.97 [0.77-1.23], 0.84 [0.66-1.06] and 0.72 [0.54-0.96]; P-trend = .01) after adjusting for demographical/socioeconomic factors and sedentary time, but this association became non-significant after further adjustment for cardiometabolic traits. Notably, the association of sedentary time with GGT elevation was significant both in individuals meeting the US Physical Activity Guidelines for Americans (MVPA ≥150 minutes/week) and in those who did not (both P-trend ≤ .003).
Our findings suggest that objectively measured sedentary time is independently associated with elevated ALT and GGT in US Hispanics/Latinos.
久坐不动和缺乏身体活动与不良健康后果相关,但其与肝酶升高的关联仍不确定。
在西班牙裔社区健康研究/拉丁裔研究中的10385名美国西班牙裔/拉丁裔人群中,我们研究了通过加速度计测量的久坐时间和中等到剧烈身体活动(MVPA)与肝酶升高之间的关联。丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶和γ-谷氨酰转移酶(GGT)升高定义为特定性别最高的十分位数。使用加权泊松回归计算患病率比值(PRs)和95%置信区间(CIs)。
在调整人口统计学/社会经济因素和MVPA后,久坐时间四分位数增加与ALT升高患病率较高相关(PRs [95% CI] = 1.0,1.17 [0.92 - 1.47],1.21 [0.96, 1.53] 和1.51 [1.13 - 2.02];P趋势 = 0.007)以及GGT升高相关(PRs [95% CI] = 1.0,1.06 [0.82 - 1.36],1.35 [1.06 - 1.73] 和1.66 [1.27 - 2.16];P趋势 = 0.0001)。在进一步调整包括体重指数、腰臀比、血脂和胰岛素抵抗稳态模型评估等心脏代谢特征后,这些关联减弱但仍显著。相比之下,在调整人口统计学/社会经济因素和久坐时间后,MVPA四分位数增加与ALT升高患病率较低相关(PRs [95% CI] = 1.0,0.97 [0.77 - 1.23],0.84 [0.66 - 1.06] 和0.72 [0.54 - 0.96];P趋势 = 0.01),但在进一步调整心脏代谢特征后这种关联变得不显著。值得注意的是,久坐时间与GGT升高的关联在符合美国身体活动指南(MVPA≥150分钟/周)的个体和不符合的个体中均显著(两者P趋势≤0.003)。
我们的研究结果表明,在美国西班牙裔/拉丁裔人群中,客观测量的久坐时间与ALT和GGT升高独立相关。