Alanine aminotransferase, gamma-glutamyltransferase, and incident diabetes: the British Women's Heart and Health Study and meta-analysis.
Alanine aminotransferase, gamma-glutamyltransferase, and incident diabetes: the British Women's Heart and Health Study and meta-analysis.
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DOI：
10.2337/dc08-1870
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发表时间：
2009-04
期刊：
影响因子：
16.2
通讯作者：
Lawlor DA
中科院分区：
文献类型：
--
作者：
Fraser A;Harris R;Sattar N;Ebrahim S;Davey Smith G;Lawlor DA
评估和比较丙氨酸氨基转移酶（ALT）和γ-谷氨酰转移酶（GGT）与糖尿病发病的关系。英国妇女心脏和健康研究中，ALT和GGT被认为是糖尿病的决定因素，该研究对4,286名60-79岁的妇女进行了队列研究（中位随访时间为7.3年）。对21项前瞻性、基于人群的超声检查研究进行了系统回顾和荟萃分析，这些研究诊断非酒精性脂肪肝（NAFLD）、ALT和GGT是糖尿病的决定因素，并比较了ALT和GGT与糖尿病的相关性。超声诊断的NAFLD与糖尿病发病风险增加一倍以上相关（三项研究）。ALT和GGT都可以预测糖尿病。ALT每增加一个单位，糖尿病的完全校正风险比（HR）为1.83（95% CI 1.57-2.14，I2 = 8%），GGT为1.92（1.66-2.21，I2 = 55%）。为了直接比较ALT和GGT作为糖尿病的决定因素，使用包括两种标志物结果的研究数据估计ALT和GGT分布顶部与底部四分之一的糖尿病完全校正风险。ALT的HR为2.02（1.59-2.58，I2 = 27%），GGT的HR为2.94（1.98-3.88，I2 = 20%），表明GGT可能是更好的预测因子（P = 0.05）。研究结果与肝脏脂肪在糖尿病发病机制中的作用一致。GGT可能是一个比ALT更好的糖尿病预测因子，但需要直接测定肝脏脂肪含量、ALT和GGT的额外研究来证实这一发现。
To estimate and compare associations of alanine aminotransferase (ALT) and γ-glutamyltransferase (GGT) with incident diabetes. ALT and GGT were studied as determinants of diabetes in the British Women's Heart and Health Study, a cohort of 4,286 women 60–79 years old (median follow-up 7.3 years). A systematic review and a meta-analysis of 21 prospective, population-based studies of ultrasonography, which diagnosed nonalcoholic fatty liver disease (NAFLD), ALT, and GGT as determinants of diabetes, were conducted, and associations of ALT and GGT with diabetes were compared. Ultrasonography-diagnosed NAFLD was associated with more than a doubling in the risk of incident diabetes (three studies). ALT and GGT both predicted diabetes. The fully adjusted hazard ratio (HR) for diabetes per increase in one unit of logged ALT was 1.83 (95% CI 1.57–2.14, I2 = 8%) and for GGT was 1.92 (1.66–2.21, I2 = 55%). To directly compare ALT and GGT as determinants of diabetes, the fully adjusted risk of diabetes in the top versus bottom fourth of the ALT and GGT distributions was estimated using data from studies that included results for both markers. For ALT, the HR was 2.02 (1.59–2.58, I2 = 27%), and for GGT the HR was 2.94 (1.98–3.88, I2 = 20%), suggesting that GGT may be a better predictor (P = 0.05). Findings are consistent with the role of liver fat in diabetes pathogenesis. GGT may be a better diabetes predictor than ALT, but additional studies with directly determined liver fat content, ALT, and GGT are needed to confirm this finding.
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DOI：
10.1007/bf02915659
发表时间：
1996-08-01
影响因子：
3
作者：
Cheng, X;Hiskey, JB
通讯作者：
Hiskey, JB
影响因子：
5
作者：
GREENLAND, S;LONGNECKER, MP
通讯作者：
LONGNECKER, MP
影响因子：
3.2
作者：
Hanigan, MH;Frierson, HF
通讯作者：
Frierson, HF
影响因子：
7.7
作者：
Sattar, N;Scherbakova, O;Shepherd, J
通讯作者：
Shepherd, J
影响因子：
16.2
作者：
Perry, IJ;Wannamethee, SG;Shaper, AG
通讯作者：
Shaper, AG