Zheng Kunjie, Li Xiaolong, Rong Yihua, Wang Xuejing, Hou Liping, Gu Wei, Hou Xiaoyu, Guan Yunpeng, Liu Lifang, Geng Jianlin, Song Guangyao
Department of Internal Medicine, Hebei Medical University, Shijiazhuang, Hebei, People's Republic of China.
Department of Endocrinology, Hengshui People's Hospital, Hengshui, Hebei, People's Republic of China.
Diabetes Metab Syndr Obes. 2024 Jun 6;17:2273-2281. doi: 10.2147/DMSO.S461876. eCollection 2024.
Elevated serum gamma-glutamyltranspeptidase (GGT) is an independent marker of the activation of systemic inflammation, while conditions associated with elevated triglyceride (TG) levels, such as type 2 diabetes, non-alcoholic fatty liver disease, obesity, and metabolic syndrome, are associated with an increased inflammatory burden. Moreover, serum liver enzymes (GGT, alanine aminotransferase [ALT], aspartate aminotransferase [AST], and alkaline phosphatase [ALP]) are associated with metabolic syndrome and its components, including hypertriglyceridemia. However, the relationship between liver enzymes and postprandial hypertriglyceridemia (PHTG) remains unclear. Therefore, in this study we conducted oral fat tolerance tests (OFTTs) to understand the differences in serum liver enzyme levels among individuals with different lipid tolerance levels and their correlation with PHTG.
For the OFTT, we enrolled 202 non-diabetic volunteers whose fasting triglyceride (TG) levels were less than 1.7 mmol/L in this case-control study. The participants were categorized into two groups according to the TG levels at the 0- and 4-h OFTT: a postprandial normal TG (PNTG) group and a PHTG group. Routine fasting serum biochemical indices, liver enzyme (GGT, ALT, AST, and ALP) levels, and 0- and 4-h OFTT lipid levels were assessed.
The PHTG group had significantly higher serum GGT and ALT levels and a lower AST/ALT ratio than those in the PNTG group. However, no significant difference was observed in AST and ALP levels compared with the PNTG group. After adjusting for major confounders, logistic regression analysis indicated a significant correlation between serum GGT and PHTG (odds ratio = 1.168, P < 0.001), but not with ALT level, AST level, AST/ALT ratio, and ALP level. The receiver operating characteristic curve analysis demonstrated that the serum GGT level was an effective predictor of PHTG.
Serum GGT levels are significantly associated with PHTG risk and serve as an effective biomarker for early identification.
血清γ-谷氨酰转移酶（GGT）升高是全身炎症激活的独立标志物，而与甘油三酯（TG）水平升高相关的疾病，如2型糖尿病、非酒精性脂肪性肝病、肥胖症和代谢综合征，都与炎症负担增加有关。此外，血清肝酶（GGT、丙氨酸氨基转移酶[ALT]、天冬氨酸氨基转移酶[AST]和碱性磷酸酶[ALP]）与代谢综合征及其组分，包括高甘油三酯血症有关。然而，肝酶与餐后高甘油三酯血症（PHTG）之间的关系仍不清楚。因此，在本研究中，我们进行了口服脂肪耐量试验（OFTT），以了解不同脂质耐受水平个体的血清肝酶水平差异及其与PHTG的相关性。
在本病例对照研究中，对于OFTT，我们纳入了202名空腹甘油三酯（TG）水平低于1.7 mmol/L的非糖尿病志愿者。根据OFTT 0小时和4小时时的TG水平，将参与者分为两组：餐后正常TG（PNTG）组和PHTG组。评估常规空腹血清生化指标、肝酶（GGT、ALT、AST和ALP）水平以及OFTT 0小时和4小时时的血脂水平。
PHTG组的血清GGT和ALT水平显著高于PNTG组，AST/ALT比值低于PNTG组。然而，与PNTG组相比，AST和ALP水平未观察到显著差异。在调整主要混杂因素后，逻辑回归分析表明血清GGT与PHTG之间存在显著相关性（比值比=1.168，P<0.001），但与ALT水平、AST水平、AST/ALT比值和ALP水平无关。受试者工作特征曲线分析表明，血清GGT水平是PHTG的有效预测指标。
血清GGT水平与PHTG风险显著相关，是早期识别的有效生物标志物。
