Department of Rheumatology and Clinical Immunology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, Henan, 450003, China.
Department of Gynecology, Henan Provincial People's Hospital, Zhengzhou, Henan, 450003, China.
Lipids Health Dis. 2024 Sep 12;23(1):295. doi: 10.1186/s12944-024-02281-z.
A persistent redox state and excessive reactive species involved in carbohydrate and lipid metabolism lead to oxidative damage in the liver, however, how fasting plasma concentrations of lipids and glucose are associated with fasting blood levels of alanine transaminase (ALT) and aspartate transaminase (AST) remains to be evaluated in large-scale population.
A cross-sectional study with 182,971 residents aged 18 to 92 years; multidimensional stratified analyses including quantile linear regression analysis and sex stratification were adopted to improve the quality of the evidence.
The associations between the concentrations of non-HDL-C and triglyceride and ALT levels were positive, stronger in males in each quantile of ALT levels and the coefficients expanded with increasing ALT levels at slopes of 3.610 and 5.678 in males and 2.977 and 5.165 in females, respectively. The associations between the HDL-C concentrations and ALT levels were negative, also stronger in males in each quantile and the coefficients expanded with increasing ALT levels at slopes of -7.839 in females and - 5.797 in males. The associations between glucose concentrations and ALT levels were positive, but stronger in females in each quantile and the coefficients expanded with increasing ALT levels at slopes of 1.736 in males and 2.177 in females, respectively. Similar pattern consist of relatively weaker coefficients and slops were observed between concentrations of non-HDL-C, triglyceride and glucose and AST levels. The associations between albumin concentration and concentrations of blood lipids and glucose were relatively steady across all quantiles.
The dose dependent effect between blood concentrations of lipids and glucose and liver function changes suggests that excessive carbohydrate and lipid metabolism may cause subclinical liver damage. Long term sustained primary and secondary inflammatory factors produced in the liver might be transmitted to adjacent organs, such as the heart, kidneys, and lungs, to cause and/or exacerbate pathological changes in these visceral organs.
碳水化合物和脂质代谢中涉及的持续氧化还原状态和过量的活性物质导致肝脏氧化损伤，然而，在大规模人群中，空腹血糖和血脂浓度与丙氨酸转氨酶（ALT）和天冬氨酸转氨酶（AST）的空腹水平之间的关系仍有待评估。
采用横断面研究，纳入 182971 名 18 至 92 岁的居民；采用多维分层分析，包括分位数线性回归分析和性别分层，以提高证据质量。
非高密度脂蛋白胆固醇和甘油三酯浓度与 ALT 水平呈正相关，在每个 ALT 水平的分位数中，男性的相关性更强，且在斜率上，男性的系数分别为 3.610 和 5.678，女性的系数分别为 2.977 和 5.165，随着 ALT 水平的升高而扩大。高密度脂蛋白胆固醇浓度与 ALT 水平呈负相关，在每个 ALT 水平的分位数中，男性的相关性更强，且在斜率上，女性的系数分别为-7.839 和-5.797，男性的系数分别为-5.797。葡萄糖浓度与 ALT 水平呈正相关，但在每个 ALT 水平的分位数中，女性的相关性更强，且在斜率上，男性的系数分别为 1.736，女性的系数分别为 2.177，随着 ALT 水平的升高而扩大。类似的模式也存在于非高密度脂蛋白胆固醇、甘油三酯和葡萄糖与 AST 水平之间，其系数和斜率相对较弱。在所有分位数中，白蛋白浓度与血脂和血糖浓度之间的关系相对稳定。
血脂和血糖浓度与肝功能变化之间存在剂量依赖性效应，提示过度的碳水化合物和脂质代谢可能导致亚临床肝损伤。长期持续产生于肝脏的初级和次级炎症因子可能传递到相邻器官，如心脏、肾脏和肺部，导致和/或加重这些内脏器官的病理变化。
