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目的 分析丙氨酸转氨酶(ALT)升高的检出率、伴有代谢异常情况及其危险因素.方法 将12789例体检者(排除乙肝病毒感染、过量饮酒者)进行体格检查、血压、血糖、血脂、肝功、血红蛋白、尿酸、血乙肝表面抗原检测及肝脏超声检查,根据ALT升高与否(>40 U/L)分为两组,比较两组间各代谢组分的差异.结果 ALT升高的检出率为8.69%.ALT升高组的腰围、体质指数、收缩压、舒张压、总胆固醇、三酰甘油、低密度脂蛋白胆固醇、尿酸、空腹血糖、血红蛋白、总胆红素、谷氨酰转移酶、碱性磷酸酶水平均高于ALT正常组,而年龄、高密度脂蛋白胆固醇(HDL-C)水平低于ALT正常组(P<0.05).ALT升高组超重、肥胖、各型高脂血症、空腹血糖受损、糖尿病、舒张压高、高尿酸血症、脂肪肝检出率高于ALT正常组(P<0.05).logistic回归分析显示:患脂肪肝、舒张压、体质指数、总胆固醇、血红蛋白是ALT升高的危险因素,年龄、HDL-C是保护因素.结论 非酒精性脂肪性肝病、脂代谢紊乱、肥胖是丙氨酸转氨酶升高的重要危险因素.

Objective To investigate the prevalence of elevated serum alanine aminotransferase ( ALT) and ALT-related dysmetabolism and risk factors. Methods A total of 12 789 adult participated,with no hepatitis B virus infection or alcohol over-intake, received health check-up, including blood pressure measurement, blood glucose and lipid profile test, liver function evaluation and ultrasonography. The subjects were then assigned into two groups according to the serum level of ALT. Metabolic composition was compared between the two groups. Results The prevalence of elevated ALT activity was 8.69%. The waist circumstance,body mass index (BMI) ,systolic blood pressure (SBP) ,diastolic blood pressure (DBP) ,total cholesterol (TC) ,triglyceride (TG) , low-density lipoprotein cholesterol (LDL-C) , urine acid (UA) , fasting blood glucose (FBG) ,HbAlc,total bilirubin (TBIL) ,-y-glutamyltransferase (GGT) ,alkaline phos-phatase ( ALP) of the elevated ALT group were significantly higher than those of the normal ALT group. However,age and high-density lipoprotein cholesterol ( HDL-C) in the elevated ALT group were lower than those in the normal ALT group ( P < 0. 05 ) . The occurrence of overweight, obesity, hyperlipidemia, impaired fasting glucose,diabetes, increased DBP, hyperuricacidemia and fatty liver in the elevated serum ALT group was significantly more than that in the normal ALT group ( P < 0. 05 ) . Multiple logistic regression analysis demonstrated that fatty liver, DBP, BMI.TC, HbAlc were risk factors of elevated serum ALT. Conclusion Non-alcoholic fatty liver disease, lipid metabolic disorders and obesity may be the main risk factors of elevated ALT.