贵阳市40岁及以上男性肝脏酶学与血清LDL-C水平关系的横向研究
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摘要
目的探讨贵阳市40岁及以上男性肝脏酶学与血清LDL-C水平及分层的关系。方法选取贵阳市云岩区居住5年以上、年龄≥40岁的常驻居民共10140名,其中男性2 697名,检测丙氨酸转氨酶(ALT)、γ-谷氨酰转肽酶(GGT)、天门冬氨酸转氨酶(AST)水平、低密度脂蛋白胆固醇(LDL-C)等血清学指标。对肝酶进行四分位分组,采用多元Logistic回归分析不同肝酶水平与血清LDL-C水平及分层之间的关系。结果多元Logistic回归分析表明,校正了相关危险因素后,ALT、AST、GGT水平最高组LDL-C边缘升高风险均增加、LDL-C升高风险均增加、LDL-C理想水平可能性降低;LDL-C合适水平可能性增加(P均<0.05)。结论在贵阳市年龄≥40岁的中老年男性人群中,血清ALT、AST、GGT水平与血清LDL-C水平关联,血清ALT、AST、GGT水平升高者血清LDL-C边缘升高、LDL-C升高水平的风险增加,而血清LDL-C理想水平的可能性降低,血清AST、GGT水平过高或过低LDL-C合适水平的可能性均下降。
Objective To investigate the relationship between liver enzymes and serum LDL-C levels and their stratification in male aged 40 and elderly in Guiyang. Methods A total of 10140 residents aged 40 and over who lived in Yunyan District of Guiyang cIty form of ethan 5 years were selected from May to October 2011,among them, 2697 were males,with serum alanine aminotransferase(ALT),gamma-glutamyl transpeptidase(GGT),aspartate aminotransferase(AST),blood low density lipoprotein cholesterol(LDL-C) and other serological indexes. The liver enzymes were divided into four groups and the relationship between the levels of liver enzymes and serum LDL-C was analyzed by multiple logistic regression. Results After adjusting relevant risk factors by multiple logistic regression analysis, the risk of the marginal elevation of serum LDL-C in the highest level of ALT、AST、GGT group、 the risk of the elevation of serum LDL-C increased、the possibility of the ideal level of serum LDL-C decreased;the possibility of the appropriate level of serum LDL-C increased(P均<0.05).Conclusion Serum ALT, AST and GGT levels correlated with serum LDL-C levels among the middle-aged and elderly males aged 40 years and above in Guiyang. The risk of the marginal elevation of serum LDL-C and elevation of serum LDL-C increased in those with elevated serum ALT, AST and GGT levels, while the possibility of the ideal level of serum LDL-C decreased. However,when the level of serum AST and GGT was too high or too low, the possibility of the appropriate level of serum LDL-C decreased.
Objective To investigate the relationship between liver enzymes and serum LDL-C levels and their stratification in male aged 40 and elderly in Guiyang. Methods A total of 10140 residents aged 40 and over who lived in Yunyan District of Guiyang cIty form of ethan 5 years were selected from May to October 2011,among them, 2697 were males,with serum alanine aminotransferase(ALT),gamma-glutamyl transpeptidase(GGT),aspartate aminotransferase(AST),blood low density lipoprotein cholesterol(LDL-C) and other serological indexes. The liver enzymes were divided into four groups and the relationship between the levels of liver enzymes and serum LDL-C was analyzed by multiple logistic regression. Results After adjusting relevant risk factors by multiple logistic regression analysis, the risk of the marginal elevation of serum LDL-C in the highest level of ALT、AST、GGT group、 the risk of the elevation of serum LDL-C increased、the possibility of the ideal level of serum LDL-C decreased;the possibility of the appropriate level of serum LDL-C increased(P均<0.05).Conclusion Serum ALT, AST and GGT levels correlated with serum LDL-C levels among the middle-aged and elderly males aged 40 years and above in Guiyang. The risk of the marginal elevation of serum LDL-C and elevation of serum LDL-C increased in those with elevated serum ALT, AST and GGT levels, while the possibility of the ideal level of serum LDL-C decreased. However,when the level of serum AST and GGT was too high or too low, the possibility of the appropriate level of serum LDL-C decreased.
引文
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[2]Bibiloni MM,Salas R,Nunez GM,et al.Relation between Liver Transaminases and Dyslipidaemia among2-10y.o.Northern Mexican Children[J].Plos One,2016,11(5):e0155994.
[3]Sasiwarang Goya Wannamethee LL,Andrew Gerald Shaper PHW.Hepatic Enzymes,the Metabolic Syndrome and the Risk of T2DM in older men[J].Diabetes Care 2005,28(12),2913-2918.
[4]Subrata D,Prasanth P,Prashant S.A PopulationBased Cross-Sectional Study of the Association between Liver Enzymes and Lipid Levels[J].International Journal of Hepatology,2018,2018:1-8.
[5]Al-Jameil N,Khan FA,Arjumand S,et al.Associated liver enzymes with hyperlipidemic profile in type 2diabetes patients[J].International Journal of Clinical&Experimental Pathology,2014,7(7):4345-4349.
[6]Liu X,Hamnvik OPR,Chamberland JP,et al.Circulating alanine transaminase(ALT)andγ-glutamyl transferase(GGT),but not fetuin-A,are associated with metabolic risk factors,at baseline and at two-year follow-up:The prospective Cyprus Metabolism Study[J].Metabolism Clinical&Experimental,2014,63(6):773-782.
[7]Ramírezlópez G,Moránvillota S,Mendozacarrera F,et al.Metabolic and genetic markers'associations with elevated levels of alanine aminotransferase in adolescents[J].Journal of Pediatric Endocrinology&Metabolism,2018,31(4):407-414.
[8]Chen S,Guo X,Zhang X,et al.Association between elevated serum alanine aminotransferase and cardiometabolic risk factors in rural Chinese population:a crosssectional study[J].BMC Cardiovascular Disorders,2015,15(1):65.
[9]Patel DA,Srinivasan SR,Xu JH,et al.Persistent elevation of liver function enzymes within the reference range is associated with increased cardiovascular risk in young adults:the Bogalusa Heart Study[J].Metabolism Clinical&Experimental,2007,56(6):792-798.
[10]中国成人血脂异常防治指南修订联合委员会.中国成人血脂异常防治指南(2016年修订版)[J].中华心血管病杂志,2016,44(10):833-853.
[11]Updates to the standards of Medical Care in Diabetes-2018[J].Diabetes Care2018,41(9):2045-2047.
[12]Xu Y,Bi YF,Xu M,et al.Cross sectional and longitudinal association of serum alanine aminotransferase andγ-glutamil transferase with metabolic syndrome in middle-aged and elderly Chinese people[J].Journal of Diabetes,2011,3(1):38-47.
[13]Garc2A-Hermoso A,Hackney AC,Ram2Rez-V22Lez R.Ideal cardiovascular health predicts lower risk of abnormal liver enzymes levels in the Chilean National Health Survey(2009-2010)[J].Plos One,2017,12(10):e0185908.
[14]Labayen I,Ruiz JR,ortega FB,et al.Liver enzymes and clustering cardiometabolic risk factors in European adolescents:the HELENA study[J].Pediatric O-besity,2015,10(5):361-370.
[15]Siddiqui MS,Sterling RK,Luketic VA,et al.Association between high-normal levels of alanine aminotransferase and risk factors for atherogenesis[J].Gastroenterology,2013,145(6):1271-1279.
[16]Dong W,Tao C,Jie L,et al.Association of serum gamma-glutamyl transferase and ferritin with the metabolic syndrome[J].Journal of Diabetes Research,2015,2015:1-10.