Hepatic markers and development of type 2 diabetes in middle aged men and women:: a three-year follow-up study -: The DESIR study (Data from an Epidemiological Study on the Insulin Resistance syndrome)
Hepatic markers and development of type 2 diabetes in middle aged men and women:: a three-year follow-up study -: The DESIR study (Data from an Epidemiological Study on the Insulin Resistance syndrome)
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DOI：
10.1016/s1262-3636(07)70229-x
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发表时间：
2005-12-01
影响因子：
7.2
通讯作者：
Eschwège, E
中科院分区：
文献类型：
--
作者：
André, P;Balkau, B;Eschwège, E
目的：已有研究表明，主要在男性中，丙氨酸氨基转移酶(ALT)和谷丙转氨酶(GT)可预测2型糖尿病的发生。这项研究调查了肝脏标志物与3年糖尿病风险的关系。方法：从D.E.S.I.R队列队列中研究了2071名男性和2130名女性的糖尿病发病情况。结果：根据年龄调整，只有伽玛GT可以预测男女糖尿病，而ALT和天冬氨酸转氨酶(AST)只对男性有预测作用，而胆红素不能预测。在调整了传统的混杂因素和ALT活性后，发生糖尿病的优势比(OR)在基线伽马GT四分位数上增加：男性为1，3.1，2.6，5.0(P<；0.0003)，女性为1，0.9，3.2，3.5(P<；0.0 1)。在对胰岛素抵抗标志物进行额外调整后，与ALT和AST的关系不显著，体重指数或空腹血糖降低了与伽玛-GT相关的风险，在男女中，只有在男性中仍具有显著的预测性。合并男性和女性，伽玛GT高于中位数的人，如果腰围和体重指数=0.85时，患糖尿病的调整OR为13.7%(1.8%-99.8%)，如果腰围和体重指数=0.85时调整为1.7%(0.64.8%)(交互作用P<；0.007)。结论：伽玛GT是男女2型糖尿病的主要肝脏危险标志，特别是在中心性肥胖者中。
Aim: It has been shown, mainly in men, that gamma-glutamyltransferase (gamma GT) and alanine-aminotransferase (ALT) predict the development of type 2 diabetes. This study investigates the association between hepatic markers and the 3-year risk of diabetes.Methods: Incident diabetes was studied in 2071 men and 2130 women without diabetes at baseline from the D.E.S.I.R. cohort.Results: Adjusting on age, only gamma GT was predictive of diabetes in both sexes, whereas ALT and aspartate-aminotransferase (AST) were only predictive in men, and bilirubin was not predictive. After adjustment on classical confounding factors and on ALT activity, the odds ratios (OR) for incident diabetes increased across baseline gamma GT quartiles: 1, 3.1, 2.6, 5.0 in men (P < 0.0003) and 1, 0.9, 3.2, 3.5 in women (P < 0.01). The relations with ALT and AST were not significant after adjusting on gamma GT Additional adjustment on markers of insulin resistance, BMI or fasting plasma glucose attenuated the risk associated with gamma GT in both sexes, and it remained significantly predictive only in the men. Pooling men and women, those with gamma GT above the median had adjusted ORs of developing diabetes of 13.7 (1.8-99.8) if WHR >= 0.85 and 1.7 (0.6-4.8) if WHIR < 0.85 (interaction P < 0.007).Conclusion: gamma GT was the main hepatic risk marker for type-2 diabetes in both sexes, especially in subjects with central adiposity.