Xe Jin Hui：血清γ-GT濃度與血糖密切相關(guān)
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為了調(diào)查中國農(nóng)村45歲以上人群中糖尿病患病率，以及肝臟轉(zhuǎn)氨酶與血糖的關(guān)系，來自華中科技大學(xué)同濟(jì)醫(yī)學(xué)院的Xe Jin Hui教授及其團(tuán)隊進(jìn)行了一項研究，該研究發(fā)現(xiàn)在中國農(nóng)村45歲以上人群中，糖尿病前期和糖尿病的患病率相當(dāng)高。在三種肝臟轉(zhuǎn)氨酶中，血清γ-GT濃度與血糖最密切相關(guān)，并與糖尿病前期和糖尿病獨立相關(guān)。
該研究是在湖北省農(nóng)村10800例45歲以上人群中進(jìn)行的橫斷面調(diào)查。受試者接受口服葡萄糖耐量試驗（OGTT）。測量肝臟轉(zhuǎn)氨酶（ALT、AST、γ-GT）、HbA1c、血脂。同時，受試者被邀請參加一個標(biāo)準(zhǔn)問卷的單獨考試。
該研究結(jié)果表明，1.在這項調(diào)查中，空腹血糖受損（IFG）、糖耐量異常（IGT）、空腹血糖受損合并糖耐量異常（IFG+IGT）、以及糖尿病（DM）的患病率分別為3.99%、11.77%、2.6%和9.99%。
2.隨著ALT和γ-GT濃度的增加，血糖比值比（OR）逐步增加。通過γ-GT濃度、ALT濃度最高四分位數(shù)與最低四分位數(shù)患者的比較，GGT的IFG、IGT、IFG+IGT、以及DM OR分別為1.34(95%CI 0.96-1.87)、2.14(95%CI 1.75-2.61)、2.08(95%CI 1.37-3.16)、4.81(95%CI 3.79-6.09)；ALT的IFG、IGT、IFG+IGT、以及DM OR分別為2.22(95%CI 1.53-3.22)、1.04(95%CI 0.83-1.32)、2.04(95%CI 1.26-3.28)、2.36 (95%CI 1.84-3.02)。
3.從正常狀態(tài)辨別DM的γ-GT曲線下面積為0.64，ALT曲線下面積為0.57。在ROC曲線分析中，從正常狀態(tài)辨別DM的γ-GT最佳切點值為16.5IU，敏感性為71.4%，特異性為48.6%。
該研究發(fā)現(xiàn)，在中國農(nóng)村45歲以上人群中，糖尿病前期和糖尿病的患病率相當(dāng)高。在三種肝臟轉(zhuǎn)氨酶中，血清γ-GT濃度與血糖最密切相關(guān)，并與糖尿病前期和糖尿病獨立相關(guān)。
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Objective: To investigate the prevalence of diabetes (DM) and the association of liver transaminase and serum glucose over 45 years old in countryside of China.
Methods: A cross-sectional survey of 10800 people aged over 45 years was undertaken in rural of HuBei province . Participants underwent an oral glucose-tolerance test(OGTT) . Liver transaminase (ALT AST γ-GT) HbA1c blood lipid were measured .Meanwhile the participants were invited to attend a single examination and a standard questionnaire .
Result: 1. The prevalence of IFG (impaired fasting glucose ) IGT(impaired glucose tolerance) IFG+IGT (impaired fasting glucose combined with impaired glucose tolerance) and DM were 3.99% 11.77% 2.6% and 9.99% in the survey respectively.
2.With the increase of ALT and γ-GT concentrations OR for glucose increased gradually. By comparing patients in the highest quartile of γGT concentration. ALTconcentration with those in the lowest quartile OR of GGT for IFG IGT IFG+IGT and DM was 1.34(95%CI 0.96-1.87) 2.14(95%CI 1.75-2.61) 2.08(95%CI 1.37-3.16) 4.81(95%CI 3.79-6.09); OR of ALT was 2.22(95%CI 1.53-3.22) 1.04(95%CI 0.83-1.32) 2.04(95%CI 1.26-3.28) 2.36 (95%CI 1.84-3.02) respectively .
3. The area under curve forγ-GT was 0.64 and for ALT was 0.57 for discriminating DM from normal condition. In ROC curve analysis the optimal cut-off value for γ-GT to discriminate DM from normal condition was 16.5 IU with the sensitivity of 71.4% and the specificity of 48.6%.
Conclusion: The prevalence of prediabetes and DM is relatively high over 45 years in countryside of China . Serum γ-GT concentrations were the most closely related to serum glucose in three liver transaminases and were independently associated with prediabetes and diabetes.
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ADA是美國糖尿病學(xué)會 (Americn Diabetos Association)的縮寫，美國糖尿病協(xié)會縣美國重要的非贏利性衛(wèi)生姐織，旨在提供有關(guān)糖尿病的研究進(jìn)展和信息，促進(jìn)糖尿病的科研、教育、診療等，關(guān)注一切與糖尿病有關(guān)的事務(wù)。