Effects of hepatitis B virus infection, alanine aminotransferase, aspartate aminotransferase and gamma-glutamyl transferase on prediabetes and diabetes mellitus: A cohort study
Effects of hepatitis B virus infection, alanine aminotransferase, aspartate aminotransferase and gamma-glutamyl transferase on prediabetes and diabetes mellitus: A cohort study
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乙型肝炎病毒感染、丙氨酸转氨酶、天冬氨酸转氨酶和γ-谷氨酰转移酶对糖尿病前期和糖尿病的影响：一项队列研究
DOI：
10.1016/j.aohep.2019.08.008
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发表时间：
2020-03-01
影响因子：
3.8
通讯作者：
Bai, Yana
中科院分区：
文献类型：
--
作者：
Gan, Ting;Cheng, Ning;Bai, Yana
前言和目的：本研究的目的是确认乙型肝炎病毒（HBV）感染和肝酶水平是否会增加中国糖尿病前期和糖尿病（DM）的风险。材料和方法：这项前瞻性队列研究共纳入10741人。采用Cox回归分析计算危险比（hr），评价HBV感染与糖尿病及前驱糖尿病风险的关系。采用决策树和剂量反应分析探讨肝酶水平对糖尿病和前驱糖尿病的影响。结果：基线人群HBV感染率为5.31%。在非调整模型中，HBV感染组DM的HR为1.312 （95% CI, 0.529-3.254）。经性别、年龄、肝硬化等因素校正后，HBV感染组DM的HR为1.188 （95% CI, 0.478 ~ 2.951）。经性别、年龄、肝硬化、吸烟、饮酒等因素校正后，DM的HR为1.178 （95% CI, 0.473 ~ 2.934）。在进一步调整教育程度、家庭收入和职业的模型中，DM的HR为1.230 （95% CI, 0.493-3.067）。随着丙氨酸转氨酶（ALT）、谷草转氨酶（AST）和γ -谷氨酰转移酶（GGT）水平的升高，前驱糖尿病的发生风险逐渐升高（p非线性< 0.05）。ALT、GGT与糖尿病发生风险呈剂量-反应关系（p非线性< 0.05）。结论：HBV感染与糖尿病前期和糖尿病的风险无关，肝酶水平增加了糖尿病前期和糖尿病的风险。(C) 2019 foundation Clinica Medica Sur， A.C.
Introduction and objectives: The purpose of this study was to confirm whether hepatitis B virus (HBV) infection and the levels of liver enzymes would increase the risk of prediabetes and diabetes mellitus (DM) in China.Materials and methods: A total of 10,741 individuals was enrolled in this prospective cohort study. Cox regression analysis was used to calculate the Hazard ratios (HRs) to evaluate the relationships between HBV infection and the risk of DM and prediabetes. Decision trees and dose response analysis were used to explore the effects of liver enzymes levels on DM and prediabetes.Results: In baseline population, HBV infection ratio was 5.31%. In non-adjustment model, the HR of DM in HBV infection group was 1.312 (95% CI, 0.529-3.254). In model adjusted for gender, age and liver cirrhosis, the HR of DM in HBV infection group were 1.188 (95% CI, 0.478-2.951). In model adjusted for gender, age, liver cirrhosis, smoking, drinking, the HR of DM was 1.178 (95% CI, 0.473-2.934). In model further adjusted for education, family income and occupation, the HR of DM was 1.230 (95% CI, 0.493-3.067). With the increases of levels of Alanine aminotransferase (ALT), Aspartate aminotransferase (AST) and Gamma-glutamyl transferase (GGT), the risk of prediabetes was gradually increasing (Pnon-linearity < 0.05). There were dose-response relationships between ALT, GGT and the risk of DM (Pnon-linearity < 0.05).Conclusions: HBV infection was not associated with the risk of prediabetes and DM. The levels of liver enzymes increased the risk of prediabetes and DM. (C) 2019 Fundacion Clinica Medica Sur, A.C. Published by Elsevier Espana, S.L.U.