Association Analysis Of Liver Enzymes With Metabolic Syndrome In Jinchang Cohort

Objectives To explore the relationship of metabolic syndrome(MS)and its components with liver enzymes and compare the values of ALT,AST and GGT in the diagnosis of MS,in order to provide evidence-based suggestions for the enterprise to carry out early interventions of MS in the cohort by providing optimal cut-off values of liver enzymes to screen MS.Methods 17689 subjects who complied with the inclusion and exclusion criteria at baseline in the Jinchang Cohort between June 2011 and December 2013 were included in the present crosssectional study.The epidemiological data and physical examination data were collected to be analyzed.MS was defined according to the 2009 international Joint Interim Statement criteria.In addition to general intergroup comparison and correlation analysis,logistic regression analysis was performed to analyze the association of risks of MS and its components with liver enzymes levels,and semi-parametric generalized additive model was used to explore the dose-response relationship between liver enzyme levels and risk of MS.The optimal cut-off values of liver enzymes in the diagnosis of MS were obtained by using ROC curve analysis.Results 1.Increase of ALT,AST and GGT levels were significantly correlated with components of MS with diferent degrees,and the increase of GGT level showed a closest correlation with components of MS.The GGT level of subjects with any component of MS was higher than those without the corresponding component,and with the increase of GGT level,the detection rate of components of MS increased gradually both in men and women;partial correlation analysis showed that GGT was positively correlated with waist circumference,SBP,DBP,TG,and FPG,and negatively correlated with HDL-C after adjustment for age both in men and women.With adjustment for several confounders such as age,occupation and BMI in logistic regression analysis,risk of components of MS increased with the increase of GGT level compared with the GGT quartile 1 group in men;in women,risk of components of MS increased with the increase of GGT level compared with the GGT quartile 1 group except abdominal obesity and elevated blood pressure whose risks only increased in the GGT quartiles 3-4 groups.2.With adjustment for several confounders such as age,occupation and BMI in logistic regression analysis,risk of MS increased with the increase of ALT and GGT level compared with the quartile 1 group of ALT and GGT both in men and women;while AST only showed significantly correlated with increased risk of MS in the AST quartile 4 group in men.3.Semi-parametric generalized additive model analysis showed that there was dose-response relationship between risk of MS and ALT or GGT levels both in men and women.The 25% percentile value of liver enzymes were used as reference values.Risk of MS increased with the increase of ALT and GGT levels in men.With the increase of ALT and GGT levels in women,the OR value of risk of MS initially increased,then decreased and finally increased;and when ALT level increased moderately,about110~160 U/L,it was not associated with increased risk of MS.4.ROC curve analysis revealed that the optimal cut-off values(sensitivity and specificity)for ALT,AST and GGT to identify MS were 30.5 U/L(58.2% and 58.2%),37.5 U/L(36.1% and 72.1%)and 26.5 U/L(73.2% and 53.6%),respectively,in men and 19.5 U/L(67.9% and 52.7%),34.5 U/L(34.6% and 74.2%)and 20.5 U/L(64.4% and 66.9%),respectively,in women.Conclusions 1.The increase of GGT level showed a closest correlation with components of MS both in men and women.2.Risk of MS increased with the increase of ALT and GGT level,and there was dose response relationships with gender differences between them.3.GGT had the highest value in the diagnosis of MS among the there liver enzymes.The optimal cut-off values for ALT and GGT to identify MS were 30.5 U/L and 26.5 U/L,respectively,in men and 19.5 U/L and 20.5 U/L,respectively,in women.