Xe Jin Hui：血清γ-GT浓度与血糖密切相关
为了调查中国农村45岁以上人群中糖尿病患病率，以及肝脏转氨酶与血糖的关系，来自华中科技大学同济医学院的Xe Jin Hui教授及其团队进行了一项研究，该研究发现在中国农村45岁以上人群中，糖尿病前期和糖尿病的患病率相当高。在三种肝脏转氨酶中，血清γ-GT浓度与血糖最密切相关，并与糖尿病前期和糖尿病独立相关。
该研究是在湖北省农村10800例45岁以上人群中进行的横断面调查。受试者接受口服葡萄糖耐量试验（OGTT）。测量肝脏转氨酶（ALT、AST、γ-GT）、HbA1c、血脂。同时，受试者被邀请参加一个标准问卷的单独考试。
该研究结果表明，1.在这项调查中，空腹血糖受损（IFG）、糖耐量异常（IGT）、空腹血糖受损合并糖耐量异常（IFG+IGT）、以及糖尿病（DM）的患病率分别为3.99%、11.77%、2.6%和9.99%。
2.随着ALT和γ-GT浓度的增加，血糖比值比（OR）逐步增加。通过γ-GT浓度、ALT浓度最高四分位数与最低四分位数患者的比较，GGT的IFG、IGT、IFG+IGT、以及DM OR分别为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分别为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.从正常状态辨别DM的γ-GT曲线下面积为0.64，ALT曲线下面积为0.57。在ROC曲线分析中，从正常状态辨别DM的γ-GT最佳切点值为16.5IU，敏感性为71.4%，特异性为48.6%。
该研究发现，在中国农村45岁以上人群中，糖尿病前期和糖尿病的患病率相当高。在三种肝脏转氨酶中，血清γ-GT浓度与血糖最密切相关，并与糖尿病前期和糖尿病独立相关。
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.
ADA是美国糖尿病学会 (Americn Diabetos Association)的缩写，美国糖尿病协会县美国重要的非赢利性卫生姐织，旨在提供有关糖尿病的研究进展和信息，促进糖尿病的科研、教育、诊疗等，关注一切与糖尿病有关的事务。