Association Between Serum Liver Transaminase And Metabolic Syndrome And Its Components

Objective: With the development of the economy,the improvement of people’s living standards and the aging of the population,metabolic syndrome(Met S)had gradually become a major public health problem,threatening the health of all human beings.Studies had shown Met S with insulin resistance(l R)and central obesity as the central link,especially in the elderly population.In recent years,there was also a trend toward younger age.Met S mainly included obesity(abdominal obesity),insulin resistance,hypertension,blood lipids,abnormal blood sugar,etc.,and its occurrence was affected by various factors such as heredity,gender,age,unhealthy lifestyle,unreasonable dietary structure,etc.Studies found that non-alcoholic-fatty-liver disease(NAFLD)was a manifestation of Met S in the liver.In the current study,we aimed to explore the relationship between serum liver transaminase and occurrence and development of Met S from the perspective of epidemiology and discuss the mechanism of serum liver transaminase to lead to Met S,and further determine the optimal threshold of serum liver transaminase for the diagnosis of Met S,thereby guiding the diagnosis and prevention of Met S.Methods: Health checkup data from a hospital medical center was collected,including physical examination and laboratory test data.The diagnostic criteria for Met S in this study was based on Chinese Diabetes Society(CDS,2004).The AST,ALT,and AST/ALT ratio were divided into four groups(Q1,Q2,Q3,and Q4)according to the quartile method.Spearman correlation analysis and logistic regression model were used to analyze the association of serum liver transaminase with Met S and its components.The diagnostic value of serum liver transaminase for Met S was analyzed by receiver operating characteristic(ROC)curve.The additive interaction effect of serum liver transaminase and environment triggers was also analyzed.All statistical analyses were conducted using SPSS 18.0 and Graph Pad Prism 6.0 software.Results: A total of 2,218 healthy checkup subjects were included in the study.The crude prevalence of Met S was 15.1%,and the prevalence of males was higher than that of females( =28.096,P<0.01).In the male population,the AST and ALT levels of the Met S and its components were higher than the corresponding control group,and the AST/ALT ratio was lower than that of the corresponding control group.However,the AST level of Met S in the female population was not statistically significant compared to the control group(P>0.05).Spearman correlation analysis showed that ALT and AST levels were positively correlated with abnormal number of metabolic components,while AST/ALT ratio was negatively correlated with abnormal number of metabolic components.Logistic regression model was used by adjusting the age,smoking and drinking variables.In the total population,when compared to Q1 group of AST,the risk of Met S in Q3 and Q4 groups was 1.65 times and 1.98 times,respectively.When compared to Q1 group of ALT,the risk of Met S in the Q2,Q3,and Q4 groups was 2.31 times,3.62 times,and 9.16 times,respectively.When compared to Q4 group of AST/ALT,the risk of Met S in the Q1,Q2,and Q3 groups was 12.14 times,4.08 times,2.14 times.When stratified by gender,the association of males was more significant.In the total population,the ROC curve showed that the area under curves(AUCs)with 95% confidence interval(CI)of AST,ALT and AST/ALT were 0.60(0.58,0.62),0.70(0.68,0.72),and 0.714(0.70,0.73),respectively.When compared to the AUC of 0.5,the difference was statistically significant(P<0.01).The AUC of ALT and AST was statistically significant(Z=8.573,P<0.001),and the AUC of AST/ALT and AST was also statistically significant(Z=6.090,P<0.001),while there was no significant difference about the AUC of ALT and AST/ALT(Z=1.277,P=0.202).In the male population,the interaction analysis showed that there was a positive interaction between smoking and ALT,smoking and AST/ALT,alcohol and ALT,alcohol and AST/ALT on Met S.However,the interaction effect does not exist in female population.Conclusion: 1.Elevated serum AST,ALT levels and decreased AST/ALT ratio was associated with the risk of Met S and its components,especially in the male population.2.The ALT,AST/ALT ratio in the male population has a positive additive interaction with the effects of smoking and drinking on the Met S.