Study On Correlation Between Metabolic Syndrome And GGT,ALT,AST Within Normal Ranges

Objective:Analyze the correlation between liver enzymes within normal ranges and metabolic syndromeMethods:1)5667 adults to participate in health examination in Physical Examination Center of YanJi from 2011 to 2012.after excluding the measurements which were not completed,nor patient with liver diseases(hepatitis A and/or hepatitis B),2998 adults were analyzed in the final,including 896 male,2102 female.All the investigation of the contents were informed consent to the survey content.2)Collect the clinical characteristics of the study population including sex,AGE,nation.3)Height,weight were measured after subjects took off hats,shoes and coats.4)after fasting for 12 hours Blood power were also record after at least 5 min of rest in a chair,with arm supported at heart level,using a mercury sphygmomanometer,blood samples of vein were taken to measure accurate measurements of gamma glutamyltransferase(GGT),alanine amiotransferase(ALT),aspartate aminotransferase(AST),total cholesterol(TC),triglyceride(TG),High-density lipoprotein cholesterol(HDL),Low-density lipoprotein cholesterol(LDL),glucose(GLU),uric acid(UA).5)The clinical characteristics of different sexwere compared by t-text and chi-square.Liver enzymes levels of between normal group and MS group of different sex were compared by t-text.trend of different liver enzymes levels of blood pressures,blood lipids,blood glucose,uric acid from different sex were used by variance trend test.Different levels of liver enzymes of multiple metabolic of the prevalence rate were tested by trend of chi-square test.we analyzed the cutoff values for AST,ALT and GGT to predict the risk of MS by creating ROC curves;the new cutoff values for AST,ALT and GGT of different sex to predict the prevalence rate of MS were compared by chi-square.Analyses were performed using SPSS 17.0 statistical software,statistical significance was taken as being P<0.05.Results:1)The mean values of AGE,blood pressures,TG,GGT,ALT,AST levels in male were statistically significant higher than in female.The mean values of BMI,TC,HDL,LDL levels in female were statistically significant higher than in male.2)The mean values of BMI、SBP、DBP、TC、TG、LDL、GLU、UA、GGT、ALT levels were statistically significant higher in MS group,and the mean value of HDL was lower in MS group in male.The mean values of AGE、BMI、SBP、DBP、TC、TG、LDL、GLU、UA、GGT、ALT、AST levels were statistically significant higher in MS group,and the mean value of HDL was lower in MS group in female.3)The liver enzymes within references were expressed as interquartile ranges in both sex.As the GGT levels increased in male subjects BMI、SBP、DBP、TC、TG、LDL、GLU、UA、ALT、AST increased;As the ALT levels increased AGE、BMI、SBP、DBP、TC、TG、LDL、GLU、UA、GGT、AST increased;As the AST levels increased AGE、BMI、SBP、TC、TG、LDL、GLU、UA、GGT、ALT increased;As the GGT levels increased in female subjects AGE、BMI、SBP、DBP、TC、TG、LDL、GLU、UA、ALT、AST increased and HDL decreased;As the ALT levels increased BMI、SBP、DBP、TC、TG、LDL、GLU、UA、GGT、AST increased;As the AST levels increased AGE、BMI、SBP、DBP、TC、TG、LDL、GLU、UA、GGT、ALT increased and HDL decreased.4)When the sample is divided into quartiles of GGT,ALT,AST levels within normal ranges the prevalence rate of MS,obesity,hypertension,high blood lipids,high GLU were increased with increasing GGT levels in male;the prevalence rate of MS,obesity,hypertension,high blood lipids,high GLU were increased with increasing GGT levels in female;the prevalence rate of MS,obesity,high blood lipids,high GLU were increased with increasing ALT levels in male;the prevalence rate of MS,obesity,hypertension,high blood lipids,high GLU were increased with increasing ALT levels in female;the prevalence rate of hypertension were increased with increasing AST levels in male;the prevalence rate of MS,obesity,hypertension,high blood lipids were increased with increasing AST levels in female.(P<0.05)5)We analyzed the cutoff values for GGT,AST,ALT to predict the risk of MS by creating ROC curves in both sex,In male the area under curve value for GGT was 0.651(95%CI:0.603-0.699),the cutoff value was 23.5 U/L the sensitivity value was 73.6%,specificity value were 51.6%(P<0.05);the area under curve value for ALT was 0.616(95%CI:0.563-0.669),the cutoff value was 15.5 U/L the sensitivity value was 83.0%,specificity value were 30.1%(P<0.05);there is no predicting value for AST in male(P>0.05).In female the area under curve value for GGT was 0.679(95%CI:0.643-0.716),the cutoff value was 17.5 U/L the sensitivity value was 59.3%,specificity value were 69.9%(P<0.05);the area under curve value for ALT was.669(95%CI:0.633-0.705),the cutoff value was 16.5 U/L the sensitivity value was 66.2%,specificity value were 58.8%(P<0.05);the area under curve value for AST was 0.601(95%CI:0.563-0.640),the cutoff value was 22.5 U/L the sensitivity value was 42.6%,specificity value were 73.4%(P>0.05).6)Analyzing the prevalence rate of MS of abnormal GGT,ALT and AST,we found that using the new cut off of GGT 23.5 U/L,the prevalence rate of MS of abnormal GGT was 17.0%with was significant higher than the normal group in male;using the new cut off of ALT 15.5 U/L,the prevalence rate of MS of abnormal ALT was 14.6%with was significant higher than the normal group in male.Using the new cut off of GGT 17.5 U/L,the prevalence rate of MS of abnormal GGT was 18.4%with was significant higher than the normal group in female;using the new cut off of ALT 16.5 U/L,the prevalence rate of MS of abnormal ALT was 15.5%with was significant higher than the normal group in female;using the new cut off of AST 22.5 U/L,the prevalence rate of MS of abnormal AST was 22.5%with was significant higher than the normal group in female(P>0.05).7)Take MS as dependent variable,GGT,ALT,AST with were grouped by ROC curves as independent variable,by logistic regression analysis,non-adjusted,the odds ratio of prevalence rate of MS was 2.975 times than normal GGT group(95%CI:1.890-4.684)in male;the odds ratio of prevalence rate of MS was 2.611 times than normal ALT group(95%CI:1.540-4.425)in male;the odds ratio of prevalence rate of MS was 3.375 times than normal GGT group(95%CI:2.529-4.505)in female;the odds ratio of prevalence rate of MS was 2.796 times than normal ALT group(95%CI:2.079-3.761)in female;Model 2 adjustment for AGE、LDL、TC、UA.the odds ratio of prevalence rate of MS was 2.915times than normal GGT group(95%CI:1.815-4.682)in male;the odds ratio of prevalence rate of MS was 2.367 times than normal ALT group(95%CI:1.374-4.079);in male;the odds ratio of prevalence rate of MS was 2.549 times than normal GGT group(95%CI:1.871-3.474)in female;the odds ratio of prevalence rate of MS was 2.135 times than normal ALT group(95%CI:1.564-3.474)in female;P<0.05.Conclusions:1)The mean values of GGT,ALT,BMI,blood pressures,TC,TG,LDL,GLU,UA levels were statistically significant higher and HDL level was lower in MS group of both sex.2)The prevalence rate of MS and the abnormal rate of metabolic components were increased with increasing GGT and ALT levels in both sex.3)We analyzed the cutoff values for GGT,ALT to predict the risk of MS were 23.5 U/L、15.5 U/L in male;the cutoff values for GGT,ALT to predict the risk of MS were 17.5 U/L、16.5 U/L、22.5 U/L in female.4)After adjustment for AGE、LDL、TC、UA high GGT level(male OR:2.915;female OR:2.549)and high ALT level(male OR:2.367;female OR:2.135)were the influence factors of MS in both sex.