Longitudinal Changes in Liver Aminotransferases Predict Metabolic Syndrome in Chinese Patients with Nonviral Hepatitis / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>This study explored the correlation of longitudinal changes in serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels with the incidence of metabolic syndrome (Mets) based on a dynamic health examination cohort.</p><p><b>METHODS</b>A Mets-free dynamic cohort involving 4541 participants who underwent at least three health examinations from 2006 to 2011 was included in the study. Mets was defined according to the Chinese Medical Association Diabetes Branch definition that included hypertension, obesity, hyperlipidemia, and hyperglycemia. Generalized estimating equation (GEE) model was used to analyze multivariate relative risk (RR) of repeated observations of ALT and AST in quartiles for Mets or its components according to gender.</p><p><b>RESULTS</b>In all, 826 Mets cases were reported. Adjustment of relevant parameters indicated that time-varying changes in ALT and AST levels were positively associated with the incidence of Mets in a dose-response manner. Positive association between high ALT levels and fatty liver was much stronger than that between high AST levels and fatty liver, particularly in male participants. These associations were consistently observed in the following subgroups: participants with ALT and AST levels of <40 U/L, participants with of <25 kg/m2, and participants with non-fatty liver. Furthermore, participants with 2 Mets components at baseline showed lower multivariate adjusted RRs of ALT and AST for Mets than participants with 0-1 Mets component.</p><p><b>CONCLUSION</b>These results suggested that elevated serum ALT and AST levels were early biomarkers of Mets or its components.</p>

Association between serum direct bilirubin with metabolic syndrome and its components based on a longitudinal health check-up study / 中华流行病学杂志

Objective To investigate the association between serum direct bilirubin (DBIL) with metabolic syndrome (MS) and its components.Methods A dynamic health check-up cohort study was set up from 2006 to 2011.5 258 participants who satisfied the two basic rules:1) being free of MS at the 1st health check-up program;2) having at least two intact health checks were included in this study.With generalized estimating equation (GEE) model,after adjusting for items as age,gender,smoking,drinking,alanine aminotransferase,aspartate aminotransferase,γ-glutamyltransferase,uric acid,blood urea nitrogen and white blood cells,the multivariable relative risks (RRs) of DBIL with MS and their components were analyzed.Results The RRs of DBIL for MS was 0.722 (95％ CI:0.654-0.797),which showing a dose-response.Serum DBIL was negatively associated with obesity and hyperlipidemia.Taking factors as gender and age into account,in the ＜45 years and 45-55 years groups,the RRs of DBIL for MS in females appeared as 0.516 (95％CI:0.349-0.761) and 0.435 (95％CI:0.256-0.740).And in males of ＜45 years and 45-55 years,the RRs of DBIL for MS were 0.738 (95％ CI:0.644-0.846) and 0.790 (95％ CI:0.667-0.937),respectively.Conclusions The elevated DBIL levels in serum appeared an early biomarker for MS and its components (obesity and hyperlipidemia).In particular,they may play a role in reducing the risk of MS in both females and males before 55 years of age.