| Aim: The study explores the association between liver enzyme and metabolic syndrome(MS); to establish the optimal liver enzymes’ cut-off points for the MS in adult people.Methods: In the cross-sectional study, 12454 subjects were selected, aged between 18 and 94 years, recruited from Tianjin Chronic Low-Grade Systemic Inflammation and Health Cohort Study. The subjects were agreed to written informed consent prior to participation in this study. The variables were age, sex, body mass index(BMI), waist circumference, smoking and drinking status, history of diseases and family history of diseases(cardiovascular disease,Hypertension, Diabetic, Hyperlipemia), systolic blood pressure(SBP), diastolic blood pressure(DBP), total cholesterol(TC), high-density lipoprotein cholesterol(HDL-C), low density lipoprotein cholesterol(LDL-C), triglyceride(TG), fasting blood sugar(FBG), 2 hour-postprandial plasma glucose(2h PG), alanine transaminase(ALT), aspartate aminotransferase(AST), alkaline phosphatase(ALP), gamma-glutamyl transpeptidase(GGT). MS was defined according to the criteria of the Chinese medical doctor association branch of diabetes of 2013. Participants were diagnosed as MS patients when they presented three or more of the following components: elevated waist circumference(≥90cm in male, ≥85cm in female), TG ≥1.70mmol/L, HDL<1.04mmol/L, elevated blood pressure( SBP ≥130mm Hg, DBP≥80mm Hg), and elevated blood glucose(FBG≥6.1mmol/Lor 2h PG ≥7.8mmol/L. After adjustment for age, sex, BMI, smokeing status, drinking intake and the family history, we used Spearman partial correlation analysis to evaluate the association between the components of MS and liver enzyme, use multivariable logistic regression analysis exam the relationships between liver enzymes categories and MS, use ROC curve analysis the liver enzyme in predict the prevelance of MS and calculate the cut-off point.Results:The prevelance of MS in the subjects was 26.92(34.91% in male, 15.75% in female). And the prevelance of elevated waist ci T, AST, ALP, GGT were associated with the componets of MS(waist circumference, SBP, DBP, TG, HDL-C, FBG) in all subjects(P<0.005). Similar results have been found in males. However, ALT has no association with SBP, AST has no association with waist circumference and SBP in female subjects.In the multivariable logistic regression analysis, after adjustment for age, BMI, smokeing status, drinking intake and the family history, the presences of MS were higher in the fourth categories of AST, ALT, ALP, GGT than in the first category, the adjusted OR(95% CI) for MS were 2.57(2.22, 2.99), 1.26(1.12, 1.43), 2.47(2.15, 2.83) and 4.72(4.00, 5.59)(P for trend <0.001) respectively in all subjects. Male subjects in the fourth category of ALT, AST, ALP, GGT, the adjusted OR(95% CI) for MS were 2.36(2.01, 2.79), 1.28(1.11, 1.48), 2.10(1.80, 2.45) and 4.16(3.49, 4.97)(P for tend, P<0.001), while the females in the fourth category of ALT, AST, ALP, GGT were 1.86(1.46, 2.39),1.03(0.82, 1.29), 3.41(2.48, 4.77) and 5.16(3.88, 6.95)(the AST P for trend P=0.502, other are P<0.001).ROC curve can be used to assess the diagnostic performance of liver enzymes in MS. The areas under curve(AUC)(95%CI) of ROC with ALT, AST, ALP, GGT in both subjects were 0.68(0.67, 0.69), 0.58(0.57, 0.59), 0.61(0.60, 0.62), 0.73(0.72, 0.74),respectively, in the male subjects were0.64(0.62, 0.65), 0.55(0.54, 0.57), 0.57(0.55, 0.58), 0.67(0.66, 0.69),respectively, in the female subjects were0.65(0.63, 0.67), 0.56(0.54, 0.59), 0.70(0.68, 0.71), 0.73(0.71, 0.75). The cut-off point(sensitivity, specificity) of ALT, AST, ALP, GGT for diagnosis of MS were23.50U/L(0.59, 0.67), 23.50U/L(0.40, 0.73), 60.50U/L(0.67, 0.49),24.50U/L(0.70, 0.41) respectively, in male subjects, these values were25.50U/L(0.56, 0.64), 27.50U/L(0.28, 0.82),60.50U/L(0.51, 0.59), 27.50U/L(0.72, 0.53) respectively, in female subjects, these values were18.50U/L(0.61, 0.63), 23.50U/L(0.32, 0.79), 60.50U/L(0.78, 0.52),16.50U/L(0.74, 0.62) respectively.Conclusion:Liver enzymes are independently associated with MS.The ability of liver enzyme in diagnosising the MS: in all subjects, GGT>ALT>ALP>AST, in male subjucts GGT>ALT>ALP>AST,in female subjects GGT>ALP>ALT>AST.The liver enzymes have diagnostic performance for detecting MS in adult population.Further studies are need to explore whether these liver enzymes cut-off point is useful for assisting the diagnosis of MS. |
