He Chih-Tsueng, Chen Fang-Yu, Kuo Chun-Heng, Lin Chung-Yu, Pei Dee, Pitrone Pietro, Chen Jin-Shuen, Wu Chung-Ze
Department of Internal Medicine, Division of Endocrinology and Metabolism, School of Medicine, College of Medicine, Taipei Medical University, Taipei City, Taiwan, R.O.C.
Department of Internal Medicine, Division of Endocrinology and Metabolism, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan, R.O.C.
Medicine (Baltimore). 2025 Mar 21;104(12):e41913. doi: 10.1097/MD.0000000000041913.
Type 2 diabetes mellitus is a significant health concern among elderly individuals in Taiwan, and liver dysfunction, particularly nonalcoholic fatty liver disease, is prevalent in this population. Gamma-glutamyl transferase (γ-GT), a key enzyme involved in glutathione metabolism, has been linked to metabolic disorders, including insulin resistance (IR) and diabetes. However, its association with insulin secretion phases (first-phase insulin secretion, FPIS; second-phase insulin secretion, SPIS) and glucose effectiveness (GE) remains unclear. This study aimed to investigate these relationships in elderly nonobese Chinese individuals. A total of 10,933 participants (5082 men and 5851 women) aged ≥ 65 years were enrolled. Participants were classified based on metabolic syndrome (MetS) status and γ-GT quartiles. Blood samples were analyzed for γ-GT, fasting plasma glucose, insulin resistance, and lipid profiles. The study used established equations to calculate IR, FPIS, SPIS, and GE. Pearson correlation analysis and statistical models were applied to assess the associations. 768 men and 794 women had MetS. Those with MetS had higher IR, FPIS, SPIS, γ-GT levels, and lower GE. Higher γ-GT levels were significantly associated with MetS components and increased IR, FPIS, SPIS, and decreased GE. GE had the strongest negative correlation (r = -0.198 for men, -0.158 for women), followed by positive correlations with IR (r = 0.183 for men, 0.132 for women), SPIS (r = 0.099 for men, 0.060 for women), and FPIS (r = 0.028 for men, 0.048 for women). γ-GT was positively associated with IR, FPIS, and SPIS but negatively correlated with GE in elderly individuals. Among the 4 diabetes factors, GE exhibited the strongest correlation with γ-GT, followed by IR, SPIS, and FPIS. These findings highlight the need for further research into the role of γ-GT in glucose metabolism and potential clinical implications for elderly nonobese Chinese populations.
2型糖尿病是台湾老年人群中一个重大的健康问题，并且肝功能障碍，尤其是非酒精性脂肪性肝病，在该人群中很普遍。γ-谷氨酰转移酶（γ-GT）是参与谷胱甘肽代谢的一种关键酶，它与包括胰岛素抵抗（IR）和糖尿病在内的代谢紊乱有关。然而，其与胰岛素分泌阶段（第一阶段胰岛素分泌，FPIS；第二阶段胰岛素分泌，SPIS）以及葡萄糖有效性（GE）之间的关联仍不清楚。本研究旨在调查老年非肥胖中国人群中的这些关系。总共招募了10933名年龄≥65岁的参与者（5082名男性和5851名女性）。参与者根据代谢综合征（MetS）状态和γ-GT四分位数进行分类。对血样进行γ-GT、空腹血糖、胰岛素抵抗和血脂谱分析。该研究使用既定公式来计算IR、FPIS、SPIS和GE。采用Pearson相关性分析和统计模型来评估关联。768名男性和794名女性患有MetS。患有MetS的人具有更高的IR、FPIS、SPIS、γ-GT水平以及更低的GE。更高的γ-GT水平与MetS组分显著相关，并且与IR、FPIS、SPIS升高以及GE降低相关。GE具有最强的负相关性（男性r = -0.198，女性r = -0.158），其次是与IR（男性r = 0.183，女性r = 0.132）、SPIS（男性r = 0.099，女性r = 0.060）和FPIS（男性r = 0.028，女性r = 0.048）的正相关性。在老年人中，γ-GT与IR、FPIS和SPIS呈正相关，但与GE呈负相关。在4种糖尿病因素中，GE与γ-GT的相关性最强，其次是IR、SPIS和FPIS。这些发现凸显了进一步研究γ-GT在葡萄糖代谢中的作用以及对老年非肥胖中国人群潜在临床意义的必要性。
