孟加拉国一家三级医院成年人中肥胖和血清γ-谷氨酰转移酶与空腹血糖受损的关联。

Association of Obesity and Serum Gamma Glutamyl Transferase with Impaired Fasting Glucose in Adults at a Tertiary Level Hospital of Bangladesh.

机构信息

Dr Farhana Sharmin, Lecturer, Department of Community Medicine, Mymensingh Medical College, Mymensingh, Bangladesh; E-mail:

出版信息

Mymensingh Med J. 2022 Jul;31(3):614-621.

PMID:35780341

Abstract

Obesity is a worldwide health concern due to its rising tendency both in developing and developed countries. Obesity is known to be associated with a number of disorders including type 2 diabetes mellitus, hypertension and cardiovascular diseases. Gamma glutamyl transferase (GGT) is synthesized in liver. GGT is considered as an oxidative stress marker. Serum GGT is increased in patients with cardiovascular diseases and diabetes mellitus (DM). Impaired fasting glucose (IFG) is a risk factor for cardiovascular diseases. The aim of this study was to find out the association of obesity and serum GGT with IFG. This cross-sectional analytical study was conducted in the Biochemistry department of Sir Salimullah Medical College, Dhaka from March 2018 to February 2019. The ages of the subjects were 25-55 years. The study subjects were 120 and were divided into two groups. The groups were Normal fasting glucose (NFG) group and IFG group according to WHO diagnostic criteria. Body mass index (BMI) was used as a measure of general obesity and waist circumference (WC) and waist-hip ratio (WHR) were used as measures of abdominal or central obesity. OGTT was performed from collected blood. GGT and lipid profile were measured from serum. In IFG group, BMI, WC, WHR and GGT levels were significantly elevated (p<0.01) than NFG group i.e. BMI (22.70±1.35 vs. 28.37±2.33kg/m²), WC (79.96±5.31 vs. 93.42±4.21cm), WHR (0.92±0.06 vs. 0.97±0.07), and GGT (24.19±8.41 vs. 67.23±14.40U/L). Fasting Plasma Glucose (FPG) level were significantly higher (p<0.01) in obese group than over weight and normal BMI groups 4.70±0.08, 5.30±1.3 and 6.50±0.3 respectively. FPG were higher in male and female obese group than normal WC group (4.8±1.1 vs. 6.3±0.60mmol/L) and (4.4±0.7 vs. 6.2±0.80mmol/L). Odds Ratio (OR) and (95% CI) for IFG were 6.53 and 21.0 with BMI tertile 2(23.1- 27.5kg/m²) and tertile 3(≥27.5kg/m²) where T₁ (<23.0kg/m²) was considered as reference category. OR for IFG were 4.1 and 20.25 with GGT tertile 2(24.0-42.0) U/L and tertile 3(>42.0) U/L where T₁ (<24.0) U/L was considered as reference category. Multiple regression analysis shows positive correlation of FPG with BMI, WC, WHR and GGT.

摘要

肥胖是一个全球性的健康问题，因为它在发展中国家和发达国家都呈上升趋势。肥胖与许多疾病有关，包括 2 型糖尿病、高血压和心血管疾病。γ-谷氨酰转移酶（GGT）在肝脏中合成。GGT 被认为是氧化应激的标志物。心血管疾病和糖尿病患者的血清 GGT 增加。空腹血糖受损（IFG）是心血管疾病的一个危险因素。本研究旨在探讨肥胖和血清 GGT 与 IFG 的关系。这是一项横断面分析研究，于 2018 年 3 月至 2019 年 2 月在达卡的萨尔马利乌勒医学学院生物化学系进行。受试者年龄在 25-55 岁之间。研究对象为 120 人，分为两组。根据世界卫生组织的诊断标准，将两组分为正常空腹血糖（NFG）组和 IFG 组。体重指数（BMI）是衡量一般肥胖的指标，腰围（WC）和腰臀比（WHR）是衡量腹部或中心肥胖的指标。从收集的血液中进行 OGTT。从血清中测量 GGT 和血脂谱。在 IFG 组中，BMI、WC、WHR 和 GGT 水平显著升高（p<0.01），而 NFG 组为 BMI（22.70±1.35 与 28.37±2.33kg/m²）、WC（79.96±5.31 与 93.42±4.21cm）、WHR（0.92±0.06 与 0.97±0.07）和 GGT（24.19±8.41 与 67.23±14.40U/L）。与超重和正常 BMI 组相比，肥胖组的空腹血浆葡萄糖（FPG）水平显著升高（p<0.01），分别为 4.70±0.08、5.30±1.3 和 6.50±0.3mmol/L。与正常 WC 组相比，男性和女性肥胖组的 FPG 水平更高（4.8±1.1 与 6.3±0.60mmol/L）和（4.4±0.7 与 6.2±0.80mmol/L）。IFG 的优势比（OR）和（95%CI）为 6.53 和 21.0，BMI 三分位数 2（23.1-27.5kg/m²）和三分位数 3（≥27.5kg/m²），其中 T₁（<23.0kg/m²）被认为是参考类别。IFG 的 OR 为 4.1 和 20.25，GGT 三分位数 2（24.0-42.0）U/L 和三分位数 3（>42.0）U/L，其中 T₁（<24.0）U/L 被认为是参考类别。多元回归分析显示，FPG 与 BMI、WC、WHR 和 GGT 呈正相关。