肝酶升高者发生糖尿病风险也高

hxq2007

Liver enzymes as compared with alcohol consumption in predicting the risk of type 2 diabetes: The Kansai Healthcare Study

ABSTRACT

Objective: It has been reported that moderate alcohol consumption decreased the risk of type 2 diabetes but that elevated liver enzymes increased it. The comparative importance of alcohol consumption and liver enzymes as predictors of type 2 diabetes remains unconfirmed.

Research Design and Methods: The participants included 8576 Japanese men, 40-55 years of age, without type 2 diabetes at entry. Type 2 diabetes was diagnosed if a fasting plasma glucose level was 126 mg/dL or if participants were taking oral hypoglycemic medication or insulin.

Results: During the 4-year follow-up period, we confirmed 878 cases. In multivariate models, moderate daily alcohol consumption (16.4–42.6 g ethanol/day) decreased the risk of type 2 diabetes, and higher levels of -glutamyltransferase (GGT) and alanine aminotransferase (ALT) increased the risk. In joint analyses of alcohol consumption and liver enzymes, moderate drinkers with the lowest tertile of GGT had the lowest risk of type 2 diabetes. Compared with them, nondrinkers with the highest GGT had the highest risk of type 2 diabetes (odds ratios 3.18 (95% CI, 1.75–5.76)). At every level of GGT, moderate or heavy alcohol drinkers (42.7 g ethanol/day) had a lower risk of type 2 diabetes than nondrinkers. The relationship of ALT and daily alcohol consumption with the risk of type 2 diabetes was almost the same as that of GGT.

Conclusions: GGT, ALT, and daily alcohol consumption was independently associated with the risk of type 2 diabetes. Nondrinkers with the highest GGT or ALT had a high risk of type 2 diabetes.

http://care.diabetesjournals.org/cgi/content/abstract/dc07-2184v2

作者及单位
Kyoko Kogawa Sato, M.D., Ph.D., Tomoshige Hayashi, M.D., Ph.D., Yoshiko Nakamura, M.D., Ph.D., Nobuko Harita, M.D., Takeshi Yoneda, M.D., Ginji Endo, M.D., Ph.D. and Hiroshi Kambe, M.D.
1Preventive Medicine and Environmental Health, Osaka City University Graduate School of Medicine, Osaka, Japan (K.K.S., T.H., N.H., T.Y., G.E.) and Kansai Health Administration Center, Nippon Telegraph and Telephone West Corporation, (Y.N., H.K.)
肝酶和饮酒预测2型糖尿病风险比较：关西保健研究
摘要

目的：据报道，适度饮酒降低患2型糖尿病的风险而肝酶升高则增加患病风险。饮酒和肝酶作为2型糖尿病预报者的相对重要性仍未知。

研究设计和方法：参与者包括8576日本男性，年龄40-55岁，无2型糖尿病记录。参与者空腹血糖水平达到126 mg/dL或服用口服降糖药或胰岛素被诊断为2型糖尿病。

结果：4随访期里，共确认了878例。多变量模型中，适度每日饮酒(16.4–42.6克乙醇/天)降低了2型糖尿病的风险 ，而较高的谷氨酰转移酶(GGT)和丙胺酸氨基转移酶(ALT)水平增加了风险。饮酒和肝酶联合分析中，适度饮酒伴随最低的GGT患2型糖尿病的风险最低。与之对照，禁酒者伴随最高GGT患2型糖尿病的风险最高(odds ratios 3.18 (95% CI, 1.75–5.76))。在各GGT水平，适度或重度饮酒者(42.7克乙醇/天)较禁酒者都有较低的2型糖尿病患病风险。ALT和每日饮酒伴发2型糖尿病风险的关系几乎与GGT一样。

结论：GGT、ALT、和日常饮酒各自独立地与2型糖尿病患病风险相关联。禁酒者合并GGT或ALT 具备高的患2型糖尿病风险。