谷丙转氨酶、谷草转氨酶的动态变化与代谢综合征关联性研究

发布时间：2018-03-23 14:52

  本文选题：谷丙转氨酶　切入点：谷草转氨酶　出处：《大连医科大学》2017年硕士论文

【摘要】：目的:探讨谷丙转氨酶(Alanine transaminase,ALT)、谷草转氨酶(Aspartate transaminase,AST)的动态变化与代谢综合征(Metabolic Syndrome,MetS)发生的关联,为利用ALT、AST的动态变化预测MetS的发生提供依据。方法:回顾收集1119例健康体检者2010~2013年连续4年的体检数据,根据随访体检期间是否发生MetS将目标人群分为发生MetS组和未发生MetS组,比较两组ALT、AST指标的年平均变化率是否存在差异;利用R语言建立线性混合效应模型分析发生MetS者与未发生MetS者ALT、AST指标的动态变化趋势。利用SPSS17.0软件进行单因素以及多因素Logistic回归分析ALT、AST年平均变化率与MetS发生的关联。结果:最终收集到1119例健康体检者的体检数据。3年间80例发生MetS,MetS累计发病率为7.1%。未发生MetS组与发生MetS组的ALT、AST年平均变化率差异均有统计学意义(ALT:Z=-3.85,P=0.000;AST:Z=-3.96,P=0.000);ALT年平均变化率在2010、2011年诊断为MetS组与未发生MetS组差异均有统计学意义(P0.008);AST年平均变化率在2012年诊断为MetS组与未发生MetS组的差异有统计学意义(P0.008)。ALT的线性混合效应模型结果显示,在基线时,基线年龄为37岁的未发生MetS者logALT平均水平为1.2701U/L(1.258~1.282,P0.001),而发生MetS者的logALT要平均升高0.156U/L(0.101~0.211,P0.001);在未发生MetS者中,基线年龄每加1岁,logALT水平平均升高0.0034U/L(0.001~0.005,P0.001);基线年龄与MetS状态的负交互作用有统计学意义,即发生MetS者基线年龄每增加1岁,logALT水平反而减小0.0041U/L(-0.006~-0.002,P=0.005),说明基线年龄较小的发生MetS者,其logALT水平要高于年龄大者;测量时间点与MetS状态存在正交互作用,随访期间发生MetS者的logALT水平,在诊断为MetS前每年平均增加0.0307U/L(0.004~0.058,P0.05),而未发生MetS者,随访期间logALT水平几乎不随测量时点改变。AST的线性混合效应模型显示,基线时,基线年龄为37岁的未发生MetS者logAST均值为1.3159U/L(1.308~1.324,P0.001),而发生MetS者logAST水平平均升高0.0426U/L(0.012~0.074,P=0.008);未发生MetS者基线年龄每增加1岁logAST值增加0.0023U/L(0.001~0.003,P0.001);未发生MetS者,随访期间logAST水平每年平均下降0.0049U/L(-0.009~-0.001,P=0.002);由于基线年龄与MetS状态的负交互作用有统计学意义,发生MetS者基线年龄每增加1岁,logAST水平反而平均降低0.0019U/L(-0.004~0.000,P=0.017)。单因素Logistic回归结果得出基线年龄增加、ALT基线水平升高、ALT与AST年平均变化率增加均是MetS发生的危险因素。多因素Logistic回归结果显示基线年龄(OR值为1.042,1.025~1.059,P0.001)、ALT基线水平(OR值为1.037,1.022~1.052,P0.001)以及ALT年平均变化率(OR值为1.108,1.076~1.141,P0.001)与MetS的发生相关联。基线年龄增加、ALT水平升高、ALT年平均变化率升高是MetS发生的危险因素。结论:发生MetS者在诊断为MetS之前,血清ALT与AST水平均高于未发生MetS者,且呈现明显的逐年上升趋势;ALT年均变化率升高是MetS发生的危险因素;当ALT与AST呈现出逐年的增长趋势,即使未超出正常参考值上限,也应该警惕肝脏代谢紊乱以及MetS的发生。
[Abstract]:Objective: To investigate the effects of alanine aminotransferase (Alanine, transaminase, ALT), aspartate aminotransferase (Aspartate transaminase, AST) and the dynamic changes of metabolic syndrome (Metabolic Syndrome, MetS) the Association for the use of ALT, to predict the dynamic changes of the AST provide the basis for the occurrence of MetS. Methods: retrospectively collected medical data of 1119 cases of healthy persons 2010~2013 for 4 consecutive years, according to whether the follow-up examination occurred during the MetS of the target population is divided into MetS group and non MetS group, compared with two groups of ALT, the average annual rate of change of AST index whether there are differences; the use of R language to establish the linear mixed model analysis of MetS and non MetS ALT, dynamic the change trend of AST index. Use SPSS17.0 software for single factor and multi factor Logistic regression analysis of ALT, AST average annual change rate associated with the occurrence of MetS. Results: collected 1119 cases of physical examination The physical examination data of.3 from 80 cases of MetS, MetS cumulative incidence rate of 7.1%. occurred in MetS group and MetS group ALT, AST average annual change rate differences were statistically significant (ALT:Z=-3.85, P=0.000; AST:Z=-3.96, P=0.000; ALT) the annual average change rate in 20102011 years was diagnosed as MetS group and non MetS group the differences were statistically significant (P0.008); AST average annual change rate in 2012 for the diagnosis of the difference between MetS group and non MetS group was statistically significant (P0.008) results.ALT linear mixed effects model showed that at baseline, baseline age was 37 without MetS logALT the average level of 1.2701U/L (1.258~1.282, P0.001), and occurrence of MetS logALT 0.156U/L (0.101~0.211, P0.001 average increase); in did not occur in MetS, each with 1 years of age at baseline, logALT levels increased by an average of 0.0034U/L (0.001~0.005, P0.001); baseline age and MetS status A statistically significant negative interaction, namely the occurrence of MetS baseline for each additional 1 years of age, the level of logALT decreased 0.0041U/L (-0.006~-0.002, P=0.005), an MetS baseline age is small, the level of logALT is higher than that of older persons; there is a positive interaction. The measurement time points and MetS state, MetS occurred during follow-up the level of logALT in the diagnosis of MetS before the annual average increase of 0.0307U/L (0.004~0.058, P0.05), but not MetS, the follow-up period model of linear mixed effects logALT level hardly with the measuring point change.AST display, baseline, baseline age was 37 without MetS logAST mean 1.3159U/L (1.308~1.324 P0.001, MetS logAST), and the level of the average increase of 0.0426U/L (0.012~0.074, P=0.008); no increase in MetS per person age at baseline was 1 logAST increase in the value of 0.0023U/L (0.001~0.003, P0.001); no MetS During the follow-up period, the average annual decline of 0.0049U/L logAST levels (-0.009~-0.001, P=0.002); due to significant negative interaction between baseline age and MetS status, MetS baseline each additional 1 years of age, but the average level of logAST decreased 0.0019U/L (-0.004~0.000, P=0.017). The single factor Logistic regression results of baseline age, increased ALT at baseline, ALT and AST average annual change rate increases are the risk factors of MetS. Multivariate Logistic regression analysis showed that age at baseline (OR = 1.042,1.025~1.059, P0.001), ALT base line level (OR = 1.037,1.022~1.052, P0.001) ALT and the annual average change rate (OR = 1.108,1.076~1.141, P0.001) associated with the occurrence of MetS. The baseline age, elevated levels of ALT, ALT average annual change rate is the risk factors of MetS. Conclusion: the incidence of MetS in the diagnosis of MetS, serum AL T and AST levels were higher than those without MetS, and the obvious increasing trend; ALT average annual change rate is the risk factors of MetS; when ALT and AST showed a growth trend year by year, even if does not exceed the upper limit of normal reference values, should also be alert to the metabolic disorder of the liver and the occurrence of MetS.

【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R589

【参考文献】

相关期刊论文 前9条

1 柴三葆;孙健斌;辛思旭;杜静;袁宁;付春娟;金玲;徐丹;张晓梅;;2型糖尿病患者合并代谢综合征不同组分血脂谱分析[J];中国动脉硬化杂志;2016年04期

2 CHEN Qi Cai;XIAO Juan;ZHANG Peng Peng;CHEN Li Li;CHEN Xiao Xiao;WANG Shu Mei;;Longitudinal Changes in Liver Aminotransferases Predict Metabolic Syndrome in Chinese Patients with Nonviral Hepatitis[J];Biomedical and Environmental Sciences;2016年04期

3 张娜;邵永强;张沛绮;苏依所;倪秀程;;原发性高血压和血压正常者代谢综合征患病危险比较[J];实用预防医学;2016年03期

4 耿田;;60岁以上老年人社区健康查体异常生化指标的分析研究[J];中国老年保健医学;2016年01期

5 倪娜;杨惠元;;老年高脂血症患者血脂水平对肝功能的影响[J];中国社区医师;2015年10期

6 杨露;王炳元;;肝脏衰老的基础[J];中国临床医生杂志;2015年03期

7 ;Metabolic syndrome and non-alcoholic fatty liver disease:Asian definitions and Asian studies[J];Hepatobiliary & Pancreatic Diseases International;2007年06期

8 刘静;赵冬;王薇;刘军;孙佳艺;吴兆苏;;北京自然人群代谢综合征发病率及影响因素的研究[J];心肺血管病杂志;2007年02期

9 彭峰,林金秀,曾开淇,康晴,吴可贵;肥胖和高血压患者餐后甘油三酯代谢异常与胰岛素抵抗的关系[J];中华心血管病杂志;2003年07期

，

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