尼泊尔三级医院2型糖尿病患者肝脏转氨酶升高及其与代谢综合征的关系

Q Medicine

Clinical Lipidology Pub Date : 2018-01-01 DOI:10.1080/17584299.2018.1505313

B. D. Pardhe, Ojashpi Singh Kapali, J. Mathias, Anjeela Bhetwal, Jyotsna Shakya, P. Shrestha, Meenu Prajapati, Sajan Prajapati, Nabina Adhikari Khanal, P. Khanal

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引用次数: 7

摘要

背景:在世界范围内，代谢综合征(MetS)在2型糖尿病(T2DM)患者中的患病率估计为70%。T2DM和MetS与肝酶水平异常相关，这可能是非酒精性脂肪性肝病、肝硬化、肝细胞癌或急性肝衰竭的结果。本研究调查了T2DM患者转氨酶与MetS之间的关系。方法:对540名在尼泊尔三级医院就诊的糖尿病患者进行了为期6个月的描述性横断面研究。MetS的诊断基于国际糖尿病联合会(IDF)、国家胆固醇教育计划成人治疗小组III (NCEP ATP III)和2009年统一定义。通过粗逻辑回归和调整逻辑回归分析，确定代谢成分与肝酶之间的相关性。结果:总体而言，谷氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)和谷氨酰转移酶(GGT)的酶水平升高的患病率分别为58.9%、42.2%和59.4%。根据NCEP ATP III、IDF和Harmonized标准，met的存在率分别为23.3%、36.1%和51.9%。在二元logistic回归分析中，腰围> 102 cm (M)或> 88 cm (F)仅与所有三种肝酶升高独立相关，ALT的比值比(or) = 4.172, AST的比值比(or) = 2.795, GGT的比值比(or) = 0.245。当所有三个标准被输入多变量风险分析时，只有NCEP ATP III(+)被发现与所有三种肝酶升高独立相关。结论:在我们的糖尿病人群中，中枢性肥胖和符合NCEPATP III标准的MetS与ALT、AST和GGT升高独立相关。临床医生可能认为肝脏并发症在T2DM中是一个可以忽略的因素。目前的研究结果可能会引起更多的关注。

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Elevated liver transaminases and their association with metabolic syndrome in type 2 diabetic patients attending tertiary care hospital of Nepal

ABSTRACT Background: Worldwide, the prevalence of the metabolic syndrome (MetS) is estimated to be 70% among those with type 2 diabetes mellitus (T2DM). T2DM and MetS are associated with abnormal liver enzyme levels, which can be the result of non-alcoholic fatty liver disease, cirrhosis, hepatocellular carcinoma or acute liver failure. The present study investigated the association between transaminases and MetS in T2DM patients. Methods: A descriptive cross-sectional study was conducted over the period of 6 months among 540 diabetic patients attending a tertiary care hospital in Nepal. The diagnosis of MetS was based on International Diabetes Federation (IDF), National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) and Harmonized definition 2009. Association between metabolic components and liver enzymes was established by crude and adjusted logistic regression analysis. Results: Overall, the prevalence of elevated enzyme levels was 58.9% for alanine aminotransferase (ALT), 42.2% for aspartate aminotransferase (AST) and 59.4% for gamma-glutamyl transferase (GGT). The presence of MetS was 23.3%, 36.1% and 51.9% according to NCEP ATP III, IDF and Harmonized criteria, respectively. In the binary logistic regression analysis, waist circumference > 102 cm (M) or > 88 cm (F) was only independently associated with all three elevated liver enzymes, odds ratio (OR) = 4.172 for ALT, OR = 2.795 for AST and OR = 0.245 for GGT. When all three criteria were entered for multivariate risk analysis, only the NCEP ATP III (+) was found to be associated independently with raised all three liver enzymes. Conclusion: Central obesity and MetS following NCEPATP III criteria were independently associated with elevated ALT, AST and GGT in our diabetic population. Clinicians may consider hepatic complication as a negligible component in T2DM. The present findings may encourage more attention.

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来源期刊

Clinical Lipidology 生物-生化与分子生物学

CiteScore

0.44

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： The Journal of Clinical Lipidology is published to support the diverse array of medical professionals who work to reduce the incidence of morbidity and mortality from dyslipidemia and associated disorders of lipid metabolism. The Journal''s readership encompasses a broad cross-section of the medical community, including cardiologists, endocrinologists, and primary care physicians, as well as those involved in the treatment of such disorders as diabetes, hypertension, and obesity. The Journal also addresses allied health professionals who treat the patient base described above, such as pharmacists, nurse practitioners and dietitians. Because the scope of clinical lipidology is broad, the topics addressed by the Journal are equally diverse. Typical articles explore lipidology as it is practiced in the treatment setting, recent developments in pharmacological research, reports of treatment and trials, case studies, the impact of lifestyle modification, and similar academic material of interest to the practitioner. While preference is given to material of immediate practical concern, the science that underpins lipidology is forwarded by expert contributors so that evidence-based approaches to reducing cardiovascular and coronary heart disease can be made immediately available to our readers. Sections of the Journal will address pioneering studies and the clinicians who conduct them, case studies, ethical standards and conduct, professional guidance such as ATP and NCEP, editorial commentary, letters from readers, National Lipid Association (NLA) news and upcoming event information, as well as abstracts from the NLA annual scientific sessions and the scientific forums held by its chapters, when appropriate.