Serial metabolic measurements and conversion to type 2 diabetes in the west of Scotland coronary prevention study - Specific elevations in alanine aminotransferase and triglycerides suggest hepatic fat accumulation as a potential contributing factor
Serial metabolic measurements and conversion to type 2 diabetes in the west of Scotland coronary prevention study - Specific elevations in alanine aminotransferase and triglycerides suggest hepatic fat accumulation as a potential contributing factor
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DOI：
10.2337/db06-1256
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发表时间：
2007-04-01
期刊：
影响因子：
7.7
通讯作者：
Packard, Chris
中科院分区：
文献类型：
--
作者：
Sattar, Naveed;McConnachie, Alex;Packard, Chris
为了检查代谢变化（血脂、肝酶、血压和体重）与转化为糖尿病的潜在关联，我们分析了苏格兰西部冠状动脉预防研究试验中每6个月获得的一系列葡萄糖和其他代谢指标。86名转化为新发糖尿病的男性（“转化者”：连续两次血糖水平>= 7 mmol/l）的参数变化与860名年龄和治疗分配相匹配的“非转化者”进行了比较。确诊前18个月，与非糖尿病转化者相比，糖尿病转化者空腹血糖、体重、甘油三酯、丙氨酸转氨酶（ALT）、血压、白细胞计数升高（P < 0.01），高密度脂蛋白胆固醇降低。在18个月内，转化者的空腹血糖平均（SD）升高为1.80 (1.52)mmol/l，而非转化者为0.10 (0.57)mmol/l。在测量的参数中，与非转化者相比，转化者在18个月内只有ALT （P = 0.0005）和甘油三酯（P = 0.030）显著升高，但在基线葡萄糖浓度高（> 6.1 mmol/l）的非转化者中，这两项参数均未显著升高。最后，只有ALT持续升高预示着患糖尿病的风险更高。我们得出的结论是，空腹血糖水平的相对快速上升在糖尿病转化者中是常见的，随着时间的推移，ALT和潜在的甘油三酯的相关增加表明，肝脏脂肪积累是高危男性转化为糖尿病的一个因素。
To examine metabolic changes (lipids, liver enzymes, blood pressure, and weight) potentially associated with conversion to diabetes, we analyzed serial glucose and other metabolic measures obtained every 6 months within the West of Scotland Coronary Prevention Study trial. Changes in parameters for 86 men who converted to new-onset diabetes ("converters": two consecutive glucose levels >= 7 mmol/l) were compared with 860 "nonconverters" matched for age and treatment allocation. Eighteen months before the diagnosis, converters to diabetes had elevated (P < 0.01) fasting glucose, weight, triglyceride, alanine aminotransferase (ALT), blood pressure, and white cell count and lower HDL cholesterol compared with nonconverters. The mean (SD) increase in fasting glucose over 18 months in converters was 1.80 (1.52) mmol/l, compared with 0.10 (0.57) in nonconverters. Of parameters measured, only ALT (P = 0.0005) and triglyceride (P = 0.030) increased significantly more over the 18 months in converters compared with nonconverters, but neither parameter increased significantly in nonconverters with high baseline glucose concentrations (> 6.1 mmol/l). Finally, only sustained increases in ALT predicted a higher risk for diabetes. We conclude that a relatively rapid rise in fasting glucose levels is frequent in converters to diabetes and that associated increases over time in ALT and potentially triglyceride suggest hepatic fat accumulation as a contributing factor for conversion to diabetes in men at risk.