The Relationship Between The Metabolic Syndrome And Alanine Aminotransferase, Uric Acid, White Blood Cell Count

Objective:The Metabolic syndrome(MS) consists of a combination of metabolic abnormalities, including abdominal obesity, high blood pressure,dyslipidemia and impaired glucosemetabolism.The components of MS were risk factors of heart disease and the cerebrovascular atherosclerosis disease. In recent years,some scholars have provided some subjects like Nonalcoholic fatty live diease(NAFLD),Hyperuricemia(Hum)and Chronic inflammation [6] may have high associations with MS.So some markers like alanine aminotransferase(ALT) which estimated the liver injury of NAFLD, uric acid(UA)and white blood cell(WBC)count which reflects the state of low grade systemic inflammation maybe a new marker which diagnosed MS. But there was very seldom report that compared the relationship between the MS and ALT,UA and WBC count in China,and the sensitivity,specificity of ALT,UA and WBC count for diagnosis of MS is unknown. Based on above, the study investigate the respective associations of ALT; UA and WBC count with MS and its components,and observed the sensitivity,specificity of ALT,UA and WBC counts for diagnosis of MS.Methods:We used cross-sectional study and enrolled 1,575 health population (728 man and 847 woman) who visited our hospital for routine health examinations. Among of them, MS patients were diagnosed by modified Adult Treameant PanelⅢ(ATPⅢ). The persons with the evidences of acute(serum level of ALT or AST were higher than three times the upper limit of the reference range) or chronic viral hepatitis (a positive test for hepatitis B virus surface antigen and hepatitis C virus antiboby), alcoholic fatty liver disease and diffuse liver disease were excluded:We also excluded those who might have acute infection (total WBC counts were higher than 10×109cell/ul),renal insufficiency (serum creatinine levels wre higher than 1.2mg/dl),organ transplantation,taking immunosuppressed medicine for long-term,HIV infection,bone marrow disturbance with haematogenesis,upper airway and gastrointestinal tract infection,a variety of chronic and wasting disease, and those who currently receiving drugs which could affect the levels of hepatic enzymes, WBC counts and uric acid. Information obtained from all the subjects including demographic features, medical history and laboratory investigation was registered.MS patients were diagnosed by modified Adult Treameant PanelⅢ(ATPⅢ).Metabolic parameters and biochemical markers including ALT,UA and WBC counts were obtains. Ultrasonic were done in all individual to diagnose the fatty liver.All studied individuals were divided into two groups as with MS and without MS respectively.Then blood ALT,UA levels and WBC counts in MS and non-MS individual were compared by t-test analysis. Further, All studied individuals were divided into four groups according to the quarters of ALT,UA and WBC counts, compared the morbidity of MS in each four groups byχ2 test analysis.At last,we appraised the associations of ALT,UA and WBC counts with MS and its components by multiple logistic regression analysis,and observed the sensitivity,specificity of ALT,UA and WBC counts for diagnosis of MS by ROC curves analysis.Result:1575 individuals were enrolled in physical examination of the third hospital of HeBei province. There were 728 men and 847 women.1 The ALT,UA level and WBC counts in MS individual is 37IU/L,354μmol/L,6.86×109/L respectively, was markedly higher than that in no-MS individual (26 IU/L,271μmol/L,6.18×109/L,P<0.0001).2 In the quarters of ALT level, the morbidity of MS is 10.56%, 13.21%,23.19%,81.28%. In the quarters of UA level, the morbidity of MS is 4.60%,9.09%,49.87%,68.27%. In the quarters of WBC count, the morbidity of MS is 19.2%,24.82%,34.12%,52.43%. Byχ2 test analysis, We found the morbidity of MS in the quarters of ALT,UA and WBC counts was higher with the heightening of ALT,UA and WBC counts(P<0.0001). 3 By multiple logistic regression analysis, adjusting for age, sex, smoking history, drinking history, fatty liver,the traditional components(high fasting glucose,high triglyceride,low high density lipoprotein-choleterol, high systolic blood pressure, high diastolic blood pressure and waist circumference) of MS and ALT,UA level,WBC counts may all increase the risk of MS with corresponding OR as following:9.824,(95%CI:5.418～17.813,P<0.0001), 2.490,95%CI:1.821～3.404,P<0.0001),1.091,(95%CI:1.006-1.100,P<0.0001), 1.063,(95%CI:1.035～1.092,P<0.0001),1.062,(95%CI:1.022～1.103,P=0.002), 1.073,(95%CI:1.032～1.117,P<0.0001),1.046,(95%CI:1.026～1.067,P<0.0001), 1.012,(95%CI:1.008～1.017,P<0.0001),1.010,(95%CI:1.002～1.017,P=0.037).E xcepted the traditional components of MS, ALT might have the strongest association with MS. Furthermore, there is the association between ALT, UA and Waist Circumference, WBC count and triglygeridemia respectively.4 By ROC curves analysis, the outoff value of ALT,UA and WBC counts for diagnosis of MS were 29IU/L,315μmol/L,6.59×109/L respectively. And the sensitivity diagnosed the MS with ALT,UA and WBC counts was 80.5%, 77.5%,59.5%.Conclusion:ALT,UA and WBC counts may be the independent risk factors for MS and its components. Among the three markers, ALT might have the strongest association with MS.