【摘要】 目的分析2型糖尿病(type 2 diabetes mellitus, T2DM)患者血清肝酶与胆汁酸(bile acid, BA)的变化,探索它们之间的相互关系,了解影响肝酶水平的因素。方法收集住院治疗的T2DM患者700例,根据肝酶是否升高分为肝酶升高组(187例)和肝酶正常组(513例),再将所有患者的丙氨酸氨基转移酶(alanine aminotransferase, ALT)、谷氨酰胺转肽酶(glutamyl transferase, GGT)分别按三等分进行分组。比较两组间及ALT、GGT三等分组间BA水平差异,分析ALT、天冬氨酸氨基转移酶(aspartate aminotransferase, AST)、GGT与BA的相关性及肝酶升高的影响因素。结果肝酶升高组较肝酶正常组总胆汁酸(total bile acid,TBA)、甘胆酸(glycocholic acid, CG)升高(P<0.05);随着ALT或GGT的升高,TBA、CG逐渐升高(P<0.05)。相关性分析显示,TBA、CG与ALT、AST、GGT均呈正相关,且不受年龄、病程、BMI、腹围及糖脂代谢等的影响。Logistic回归分析显示,病程和餐后2h血糖(2h postprandial blood glucose, 2hPBG)是T2DM患者肝酶升高的影响因素。结论 T2DM患者中BA水平与肝酶的变化密切相关。更多还原

【Abstract】 Objective To analyze the association between serum liver enzymes and bile acid(BA) in patients with Type 2 diabetes mellitus(T2 DM). Methods Seven hundred patients with T2 DM admitted in endocrinology department were recruited, including 513 patients with elevated liver enzymes and 187 patients with normal liver enzymes. BA levels between the two groups were compared, and the correlation between BA and alanine aminotransferase(ALT), aspartate aminotransferase(AST), glutamyl transferase(GGT) was analyzed. Results Compared with the liver enzyme normal group, total bile acid(TBA) and glycocholic acid(CG) levels were increased in the liver enzyme elevation group(P<0.05). TBA and CG increased with the increase of ALT or GGT(P<0.05). TBA and CG were positively correlated with ALT, AST and GGT, and its relationship was not affected by age, disease course, BMI, abdominal circumference and glucose and lipid metabolism. Logistic regression analysis showed that disease course and 2 h-postprandial blood glucose(2 hPBG) levels were the influencing factors of liver enzyme elevation in T2 DM patients. Conclusion The level of BA is closely related to the changes of liver enzymes in patients with T2 DM.更多还原