The associations between birthweight and adult markers of liver damage and function
The associations between birthweight and adult markers of liver damage and function
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DOI：
10.1111/j.1365-3016.2007.00876.x
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发表时间：
2008-01-01
影响因子：
2.8
通讯作者：
Lawlor, Debbie A.
中科院分区：
文献类型：
--
作者：
Fraser, Abigail;Ebrahim, Shah;Lawlor, Debbie A.
动物和人类研究都有证据表明胎儿生长对肝脏发育和功能有影响。在随机抽取的2101名年龄在60 - 79岁的英国妇女中，研究了出生体重与成年肝损伤和功能标志物的关系。丙氨酸氨基转移酶（ALT）和γ-谷氨酰转移酶（GGT）的水平随出生体重的增加而线性下降。碱性磷酸酶（ALP）水平在出生体重分布最低的三分之一的妇女比其他妇女更高。未发现出生体重与天冬氨酸转氨酶（AST）、总胆红素和白蛋白相关的证据。在对社会阶层、体力活动、吸烟和饮酒进行全面调整后，出生体重（691 g）的一个标准差的增加与2%的（[95% CI 0%，4%]，P=0.021）ALT几何平均值降低，GGT降低4%（[95% CI 1%，6%]，P=0.008）和ALP降低2%（[95% CI 0%，3%]，P=0.001）。当调整代谢综合征的成分时，出生体重与ALT和GGT的相关性减弱，但与ALP无关。这些发现表明，影响宫内生长的因素可能会增加成人肝损伤的倾向。与代谢综合征组分调整相关性的减弱与非酒精性脂肪肝一致，表现为ALT和GGT升高，是代谢综合征的肝脏表现，也是围产期因素对该综合征的影响。
Evidence suggesting an effect of fetal growth on liver development and function stems from both animal and human studies. The association of birthweight with adult markers of liver damage and function was examined in a random sample of 2101 British women aged 60 - 79 years. Age-adjusted natural logged levels of alanine aminotransferase (ALT) and gamma glutamyltransferase (GGT) decreased linearly across increasing thirds of birthweight. Alkaline phosphatase (ALP) levels were higher in women of the lowest third of the birthweight distribution compared with other women. No evidence was found for associations of birthweight with aspartate aminotransferase (AST), total bilirubin and albumin. After full adjustment for social class, physical activity, smoking and alcohol consumption, an increase in one standard deviation of birthweight (691 g) was associated with a 2% ([95% CI 0%, 4%], P=0.021) decrease in the geometric mean of ALT, a 4% decrease in GGT ([95% Cl 1%, 6%], P=0.008) and a 2% decrease in ALP ([95% CI 0%, 3%], P=0.001). Associations of birthweight with ALT and GGT, but not with ALP, were attenuated when adjusting for components of the metabolic syndrome. These findings suggest that factors affecting intrauterine growth may increase the propensity for adult liver damage. The attenuation of associations with adjustment for components of the metabolic syndrome is in line with non-alcoholic fatty liver disease, indicated by elevated ALT and GGT, being the hepatic manifestation of the metabolic syndrome, and of the influence of perinatal factors on this syndrome.