Influence of gamma-glutamyltranspeptidase on metabolism parameter in patients with chronic hepatitis B

doi:10.3877/cma.j.issn.1674-1358.2017.02.009

Abstract

Abstract:

Objective

To investigate the influence of gamma-glutamyltranspeptidase (GGT) on metabolism parameters in patients with chronic hepatitis B (CHB).

Methods

Total of 110 patients were divided into different groups according to the levels of alanine aminotransferase (ALT), glutamic-oxaloacetic aminotransferase (AST) and GGT, respectively. The difference of metabolism indexes of patients in different groups with different ALT, AST and GGT were analyzed, respectively.

Results

The abnormal condition of metabolism indexes of patients with GGT < 1.5 ULN were rare. Compared with patients of GGT level of 2-3 ULN groups and those in > 3 ULN group, the homeostasis model assessment for insulin resistance (HOMA-IR), fasting plasma glucose (FPG) and the fatty liver proportion were significantly increased of patients with GGT level of 1.5-2 ULN group (F = 6.631, 13.839, 18.723; all P < 0.001), the level of high density lipoprotein cholesterol (HDL-c) decreased, with significant differences (χ² = 3.399, P = 0.021). The β cell function of the homeostasis model assessment (HOMA-β) also increased, but with no significant difference (F = 2.679, P = 0.051). There was no significant difference of each metabolism indexes among different ALT and AST levels groups (all P > 0.05).

Conclusions

The metabolic abnormality in CHB patients with GGT < 1.5 ULN were rare. The insulin resistance, HOMA-β decreased, abnormal glucose and lipid metabolism and hepatic lipidosis were all significant in CHB patients with GGT of 1.5-2 ULN, but as the GGT increasing, the abnormal metabolism was lessened.

Key words: Chronic hepatitis B, Gamma-glutamyltranspeptidase, Metabolism index

Dafeng Liu, Fengxian Zhou, Birong Mao, Lijuan Lan, Yaling Liu, Yong Wang, Lei Bao, Yi Xin, Xinhua Hu, Chuan Luo. Influence of gamma-glutamyltranspeptidase on metabolism parameter in patients with chronic hepatitis B[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2017, 11(02): 146-150.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhsyhlcgrbzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-1358.2017.02.009

https://zhsyhlcgrbzz.cma-cmc.com.cn/EN/Y2017/V11/I02/146

Figures/Tables 4

References 21

1	Sattar N, Scherbakova O, Ford I, et al. Elevated alanineamino-transferase predicts new-onset type 2 diabetes independently of classical risk factors, mebabolic syndrome, and C-reactive protein in the West of Scotland Coronary Prevention Study[J]. Diabetes, 2004,53(11):2855-2860
2	Tohidi M, Harati H, Hadaegh F, et al. Association of liver enzymes with incident type 2 diabetes: a nested case control study in an Iranian population[J]. BMC Endocr Disord,2008,8(1):1-6.
3	Nannipieri M, Gonzales C, Baldi S, et al. Liver enzymes, the metabolic syndrome,and incident diabetes:the Mexico City Diabetes Study[J]. Diabetes Care,2005,28(7):1757-1762.
4	Thamer C, Tschritter O, Haap M, et al. Elevated serum GGT concentrations predict reduced insulin sensitivity and increased intrahepatic lipids[J]. Horm Metab Res,2005,37(4):246-251.
5	Hong NS, Kim JG, Lee YM, et al. Different associations between obesity and impaired fasting glucose depending on serum gamma-glutamyltransferase levels within normal range: a cross-sectional study[J]. BMC Endocr Disord,2014,14(1):1-8.
6	刘大凤，曾义岚，林军, 等. 慢性乙型肝炎患者代谢异常的表现形式分析[J]. 成都医学院学报,2014,9(6):712-716
7	兰丽娟，张碧英，刘大凤, 等. 不同糖代谢状态的慢性乙型肝炎患者肝脏炎症及纤维化的差异分析[J/CD]. 中华实验和临床感染病杂志(电子版),2015,9(3):18-21.
8	刘大凤，刘亚玲，张鸿, 等. 慢性乙型肝炎患者影响肝纤维化的主要代谢因素分析[J/CD].中华实验和临床感染病杂志(电子版),2015,9(5):58-63.
9	杨德华，曾义岚，刘大凤, 等. 慢性乙型肝炎患者Fibroscan弹性值的影响因素分析[S]. 第三届全国病毒性肝炎慢性化重症化基础与临床研究进展学术会议论文汇编,2013:160-166.
10	刘大凤，曾义岚，杨德华, 等. 慢性乙肝患者Fibroscan弹性值与胰岛素抵抗的相关性分析[S]. 第三届全国病毒性肝炎慢性化重症化基础与临床研究进展学术会议论文汇编,2013:166-172.
11	张鸿，刘大凤，曾义岚, 等. 慢性乙肝Fibroscan弹性值与代谢参数的相关性分析[J]. 成都医学院学报,2013,8(1).35-38.
12	中华医学会肝病学分会, 中华医学会感染病学分会. 慢性乙型肝炎防治指南(2010年版)[S]. 中华肝脏病杂志,2011,19(1):13-24.
13	中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2010年版)[S]. 中国糖尿病杂志,2012,20(1):S1-S37.
14	刘力生. 中国高血压防治指南( 2010年版)[R]. 北京:人民卫生出版社,2010.
15	中国成人血脂异常防治指南制订联合委员会. 中国成人血脂异常防治指南[J]. 中华心血管病杂志,2007,35(5):390-419.
16	高鹏，肖萍，陈青峰, 等. 慢性乙型肝炎患者血脂水平的影响因素分析[J]. 第二军医大学学报,2011,32(12):1375-1377.
17	洪永孟，朱幼芙，吴爱华, 等. 慢性乙型肝炎患者血清脂质水平与病理分级分期的关系[J]. 世界华人消化杂志,2006,14(4):453-456.
18	李冰昱，王福生，刘慧霞. 慢性乙型肝炎患者胰岛素抵抗与临床病理特点相关性研究[J]. 中国医师杂志,2009,11(5):603-605.
19	王锦俊，王芹芹，刘欣, 等. 非酒精性脂肪性肝病患者血清preptin水平与胰岛素抵抗的相关性分析[J]. 临床肝胆病杂志,2016,32(9):1774-1777.
20	柴艳云，张锦前，凌伟, 等. 慢性乙型肝炎伴发代谢综合征影响因素分析[J]. 中华实验和临床感染病杂志(电子版),2009,3(1):50-55.
21	刘大凤，刘亚玲，曾义岚, 等. 慢性乙型肝炎患者代谢异常对肝纤维化的影响[J/CD]. 中华实验和临床感染病杂志(电子版),2016,10(5):541-545.

项目	均值（±s）	数值范围
年龄（岁）	43.86±14.38	19～76
BMI（kg/m²）	22.43±2.70	16.51～29.22
^aALT	57.00±2.00	5～185
^aAST	49.91±1.68	17～185
^aALP	95.08±1.48	31～383
^aGGT	54.71±2.52	10～939
ALB	39.53±6.79	22.1～50.1
^aTB	17.45±1.55	6.2～33.3
^aUA	311.42±1.35	83～636
GLU	6.14±1.96	4.04～12.74
TC	4.20±1.12	1.89～7.79
TG	1.25±1.08	0.27～7.70
HDL-c	1.25±0.43	0.52～2.83
LDL-c	2.54±0.93	0.98～6.22
FPG	6.13±2.19	4.04～19.01
FINS	4.64±2.55	0.27～15.42
HbA1c	7.50±1.94	5.0～13.7
^aFCP	1.36±0.99	0.005～4.057
HOMA-IR	1.31±0.94	0.048～5.52
^aHOMA-β	36.96±2.30	1.209～293.71

项目	均值（±s）	数值范围
年龄（岁）	43.86±14.38	19～76
BMI（kg/m²）	22.43±2.70	16.51～29.22
^aALT	57.00±2.00	5～185
^aAST	49.91±1.68	17～185
^aALP	95.08±1.48	31～383
^aGGT	54.71±2.52	10～939
ALB	39.53±6.79	22.1～50.1
^aTB	17.45±1.55	6.2～33.3
^aUA	311.42±1.35	83～636
GLU	6.14±1.96	4.04～12.74
TC	4.20±1.12	1.89～7.79
TG	1.25±1.08	0.27～7.70
HDL-c	1.25±0.43	0.52～2.83
LDL-c	2.54±0.93	0.98～6.22
FPG	6.13±2.19	4.04～19.01
FINS	4.64±2.55	0.27～15.42
HbA1c	7.50±1.94	5.0～13.7
^aFCP	1.36±0.99	0.005～4.057
HOMA-IR	1.31±0.94	0.048～5.52
^aHOMA-β	36.96±2.30	1.209～293.71

代谢参数	GGT水平				统计量	P值
代谢参数	≤ 1.5倍ULN组（n = 75）	1.5～2倍ULN（n = 9）	2～3倍ULN（n = 10）	3～5倍ULN（n = 16）	统计量	P值
年龄	41.56±14.38	44.67±11.99	48.40±7.62	51.38±16.44	F = 2.540	0.060
^aHOMA-β	42.07±2.19	20.34±2.70	28.67±3.05	32.77±1.85	F = 2.679	0.051
HOMA-IR	1.10±0.70	2.16±1.89	2.05±1.10	1.29±0.78	F = 6.631	0.000
FPG	5.50±1.22	9.37±4.53	7.63±2.76	6.31±1.48	F = 13.839	0.000
FINS	4.42±2.49	4.89±3.02	6.14±2.89	4.60±2.23	F = 1.390	0.250
HbA1c	7.07±1.37	8.65±1.39	8.50±3.14	6.24±1.63	F = 2.354	0.096
TC	4.22±1.05	4.80±1.56	4.19±1.27	3.73±0.94	F = 1.717	0.168
TG	1.19±1.01	1.88±1.10	1.27±0.91	1.09±0.27	F = 1.206	0.312
LDL-c	2.58±0.84	3.17±1.47	2.50±0.93	1.98±0.61	F = 0.641	0.590
HDL-c	1.27±0.37	1.07±0.35	1.19±0.39	1.29±0.71	F = 3.399	0.021
UA	335.93±88.41	298.44±52.16	290.70±123.58	305.79±80.14	F = 1.338	0.266
肝脂肪化	71/4	6/3	8/2	9/7	χ²= 18.723	0.000

代谢参数	GGT水平				统计量	P值
代谢参数	≤ 1.5倍ULN组（n = 75）	1.5～2倍ULN（n = 9）	2～3倍ULN（n = 10）	3～5倍ULN（n = 16）	统计量	P值
年龄	41.56±14.38	44.67±11.99	48.40±7.62	51.38±16.44	F = 2.540	0.060
^aHOMA-β	42.07±2.19	20.34±2.70	28.67±3.05	32.77±1.85	F = 2.679	0.051
HOMA-IR	1.10±0.70	2.16±1.89	2.05±1.10	1.29±0.78	F = 6.631	0.000
FPG	5.50±1.22	9.37±4.53	7.63±2.76	6.31±1.48	F = 13.839	0.000
FINS	4.42±2.49	4.89±3.02	6.14±2.89	4.60±2.23	F = 1.390	0.250
HbA1c	7.07±1.37	8.65±1.39	8.50±3.14	6.24±1.63	F = 2.354	0.096
TC	4.22±1.05	4.80±1.56	4.19±1.27	3.73±0.94	F = 1.717	0.168
TG	1.19±1.01	1.88±1.10	1.27±0.91	1.09±0.27	F = 1.206	0.312
LDL-c	2.58±0.84	3.17±1.47	2.50±0.93	1.98±0.61	F = 0.641	0.590
HDL-c	1.27±0.37	1.07±0.35	1.19±0.39	1.29±0.71	F = 3.399	0.021
UA	335.93±88.41	298.44±52.16	290.70±123.58	305.79±80.14	F = 1.338	0.266
肝脂肪化	71/4	6/3	8/2	9/7	χ²= 18.723	0.000

代谢参数	ALT水平				统计量	P值
代谢参数	≤ 1.5倍ULN（n = 52）	1.5～2倍ULN（n = 15）	2～3倍ULN（n = 24）	3～5倍ULN（n = 19）	统计量	P值
年龄	46.23±13.86	43.40±12.83	45.38±12.80	35.84±16.84	F = 2.648	0.053
^aHOMA-β	36.43±2.46	29.34±2.35	45.04±2.04	36.30±2.15	F = 0.820	0.486
HOMA-IR	1.21±1.01	1.46±1.15	1.34±1.15	1.36±1.25	F = 1.583	0.198
FPG	5.90±2.20	7.17±2.21	5.89±1.57	6.26±2.70	F = 1.450	0.232
FINS	4.44±2.86	4.88±1.63	5.11±2.42	4.41±2.45	F = 0.465	0.707
HbA1c	7.29±2.40	8.69±1.38	6.55±0.94	7.53±1.53	F = 1.467	0.248
TC	4.00±1.14	4.84±0.95	4.54±1.17	3.91±0.85	F = 3.576	0.017
TG	1.06±0.62	1.68±0.82	1.29±0.89	1.34±1.17	F = 1.297	0.280
LDL-c	2.35±0.94	3.12±0.95	2.75±0.93	2.36±0.64	F = 3.363	0.022
HDL-c	1.26±0.45	1.30±0.42	1.34±0.42	1.04±0.34	F = 1.979	0.122
UA	332.91±87.02	305.73±83.09	332.63±105.58	306.06±78.15	F = 0.675	0.569
SBP	119.15±11.67	118.00±11.56	117.71±11.01	116.79±11.05	F = 0.233	0.873
DBP	74.27±7.61	74.73±7.32	75.96±8.98	74.47±9.92	F = 0.234	0.873
肝脂肪化	46/6	13/2	19/5	16/3	c² = 1.172	0.760

Please choose a citation manager

Content to export