Relationship Between Liver Function Indicators And Metabolic Syndrome In Community Elderly Individuals

ObjectiveThe purposes of the study were to explore the relationship between the liver function indicators,including Alanine transaminase(ALT),Aspartate aminotransferase(AST),Total Bilirubin(TBIL),with Metabolic syndrome(MS)in the community elderly and evaluate the diagnostic efficiency of the above indicators on MS,in order to provide data and theoretical supports for community health service institutions to develop effective prevention and strategies for MS among elderly residents in the community.MethodsIn this cross-sectional study,4987 elderly residents(age ≥65 years)in a community in the Pearl River Delta who participated in annual physical examination in 2019 were selected as research objects by random cluster sampling.General demographic data(including gender,age,past medical history,tobacco and alcohol using status,sports status,etc.),anthropometry parameters[Waist circumference(WC)5 body mass index(BMI),blood pressure,etc.],serological indicators[fasting blood glucose(FPG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),Total cholesterol(TC),triglyceride(TG),ALT,AST,TBIL,etc.],and abdominal ultrasound results.Statistical analyses were performed by SPSS22.0.The measurement data were uniformly showed as X±s and t test was used for mean comparison.The counting data were expressed as n(%),and the rates were compared by χ2 test.Pearson correlation analysis was used to evaluate the relationships between liver function indicators and metabolism-related indicators.Logistic regression was used to analyze the influencing factors of MS,and the correlation between liver function indicators and MS and its components,with the correlation measured by odds ratio(OR)and 95%confidence interval(CI).The area under the curve(AUC)was calculated to assess the diagnostic efficacy and optimal cut-off point of liver function indicators.Results1.1980 males and 3007 females were included in this survey,and the overall prevalence of MS was 35.61%,including 29.19%in males and 38.84%in females.The prevalence of MS in females was significantly higher than in males.2.Logistic regression analysis indicated that the risk of MS prevalence increased significantly with the increase of ALT level or the decrease of TBIL level in both males and females.This trend were obvious while the liver function indicators were within the reference range,and however,become uncertain while beyond the reference range.3.ALT and TBIL were both significantly associated with MS components.ALT was significantly positively associated with MS components except low HDL-C in elderly males,while TBIL was significantly negatively associated with MS components except low HDL-C in elderly females.4.The AUC of ALT in MS was highest among single liver function indicators,which were 0.575(0.559-0.592),0.614(0.586-0.640)and 0.565(0.586-0.640)in the general population and in males and females,respectively.The AUC of AST/ALT in MS was highest among combined liver function indicators,which were 0.649(0.633-0.665),0.685(0.586-0.640)and 0.639(0.586-0.640)in the general population and in males and females,respectively.Besides,the sensitivity of ALT in MS diagnosis was the highest in males(0.820)and TBIL in females(0.748).Conclusion1.ALT and TBIL are both significantly associated with MS in the elderly.With the increase of ALT or the decrease of TBIL,the risk of MS increases.The trends are more obvious while the liver function indicators are within the normal range of liver function indicators.2.There are gender differences in the relationship between liver function indicators and MS and its components.ALT in males and TBIL in females were more closely related to MS and its components.3.Liver function indicators have certain potential diagnostic value for MS in the elderly,and the combination of the single indicators can further improve the efficiency,the order of which are as followed:AST/ALT>ALT/TBIL>ALT>AST>TBIL>AST/TBIL.Besides,ALT is the most sensitive liver function indicator for diagnosing MS in males and TBIL is the most sensitive indicator in females,which may be the appropriate screening indicators.