Une H, Esaki H, Momose Y, Ishii T, Watanabe D, Shigematsu T, Inoue T, Hisanaga F, Yoshinaga K, Kamo H
Department of Hygiene, School of Medicine, Fukuoka University, Japan.
Prev Med. 1994 Jul;23(4):442-6. doi: 10.1006/pmed.1994.1060.
We conducted a case-control study on liver diseases among Japanese workers to examine associations between elevated serum alanine aminotransferase (alanine aminotransferase value > or = 50 IU/liter) and selected factors such as hepatitis B surface antigen positive, hepatitis C virus antibody positive, body mass index, and alcohol drinking. Out of 3,738 workers (1,477 males and 2,261 females) in a supermarket chain, 91 workers with an elevated serum alanine aminotransferase value (> or = 50 IU/liter) were classified as cases and 182 workers with normal serum alanine aminotransferase value and without an episode of blood transfusion were randomly selected as controls.
Prevalence rates of hepatitis B surface antigen positive and hepatitis C virus antibody positive were 4.4 and 23.1% among the overall cases, 2.9 and 11.8% among the cases with 100 > alanine aminotransferase value > or = 50, and 8.7 and 56.5% among the cases with alanine aminotransferase value > or = 100. A logistic regression analysis was conducted. Odds ratios were 4.94 for hepatitis B surface antigen positive (P < 0.05) and 77.19 for hepatitis C virus antibody positive (P < 0.001). Odds ratios for body mass index increased with increasing body mass index values; 3.32 for 26 > body mass index > or = 24 (P < 0.01) and 5.03 for body mass index > or = 26 (P < 0.001). No increased risk was observed among regular drinkers of less than 27 g/day of ethanol (odds ratio is 0.23) or of 27-53 g/day of ethanol (odds ratio is 0.47). A slightly increased odds ratio of 1.35 was observed among regular drinkers of 54-81 g/day of ethanol, but this was not statistically significant.
Our results suggest that hepatitis C virus and high body mass index are predominant factors in elevated serum alanine aminotransferase levels among Japanese workers, while alcohol drinking is a minor factor.
我们对日本工人的肝脏疾病进行了一项病例对照研究，以检查血清丙氨酸氨基转移酶升高（丙氨酸氨基转移酶值≥50 IU/升）与选定因素之间的关联，这些因素包括乙肝表面抗原阳性、丙肝病毒抗体阳性、体重指数和饮酒情况。在一家连锁超市的3738名工人（1477名男性和2261名女性）中，91名血清丙氨酸氨基转移酶值升高（≥50 IU/升）的工人被分类为病例组，182名血清丙氨酸氨基转移酶值正常且无输血史的工人被随机选为对照组。
在所有病例中，乙肝表面抗原阳性和丙肝病毒抗体阳性的患病率分别为4.4%和23.1%；在丙氨酸氨基转移酶值100＞≥50的病例中，分别为2.9%和11.8%；在丙氨酸氨基转移酶值≥100的病例中，分别为8.7%和56.5%。进行了逻辑回归分析。乙肝表面抗原阳性的比值比为4.94（P＜0.05），丙肝病毒抗体阳性的比值比为77.19（P＜0.001）。体重指数的比值比随着体重指数值的增加而增加；体重指数26＞≥24时为3.32（P＜0.01），体重指数≥26时为5.03（P＜0.001）。对于每天饮用乙醇少于27克的经常饮酒者（比值比为0.23）或每天饮用乙醇27 - 53克的经常饮酒者（比值比为0.47），未观察到风险增加。在每天饮用乙醇54 - 81克的经常饮酒者中，观察到比值比略有增加，为1.35，但这在统计学上不显著。
我们的结果表明，丙肝病毒和高体重指数是日本工人血清丙氨酸氨基转移酶水平升高的主要因素，而饮酒是次要因素。
