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The Association of Aspartate Aminotransferase/Alanine Aminotransferase Ratio with Diabetic Nephropathy in Patients with Type 2 Diabetes
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy ( IF 3.3 ) Pub Date : 2021-09-07 , DOI: 10.2147/dmso.s330741 Jing Xu 1 , Xiaomin Shi 1 , Youjin Pan 1
Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy ( IF 3.3 ) Pub Date : 2021-09-07 , DOI: 10.2147/dmso.s330741 Jing Xu 1 , Xiaomin Shi 1 , Youjin Pan 1
Affiliation
Purpose: To investigate the relationship between aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT) and diabetic nephropathy (DN).
Patients and Methods: A total of 402 patients with type 2 diabetes mellitus were divided into three groups, such as normoalbuminuria (n = 196), microalbuminuria (n = 131) and macroalbuminuria (n = 75) groups. Basic information and laboratory results were collected. Serum AST/ALT, tumor necrosis factor-α (TNF-α), interleukin (IL)-2, IL-4, IL-6, IL-10 and interferon- γ (INF- γ) were also measured. DN was defined as microalbuminuria or macroalbuminuria. The estimated glomerular filtration rate (eGFR) was calculated using the following formula: 186 × (serum creatinine)− 1.154× (age)− 0.203× (0.742 if female).
Results: The AST/ALT in the macroalbuminuria group was higher than in the microalbuminuria and normoalbuminuria groups. The concentrations of tumor necrosis factor-α (TNF-α), IL-2, IL-4, IL-10 and INF-γ in the macroalbuminuria group were significantly higher than those in the two other groups. Multivariate logistical analysis showed that after adjusting confounding factors, TNF-α and high AST/ALT were independent risks for DN and macroalbuminuria. Furthermore, the AST/ALT had significantly positive correlation with TNF-α (r = 0.101, P = 0.048), IL-4 (r = 0.185, P = 0.005) and IL-6 (r = 0.274, P < 0.001) levels.
Conclusion: This study showed that high AST/ALT was an independent risk factor for the DN. Additionally, AST/ALT was positively correlated with inflammation cytokines, such as TNF-α, IL-4 and IL-6 levels.
Keywords: AST/ALT, diabetic nephropathy, inflammatory factors, tumor necrosis factor-α
中文翻译：
天冬氨酸氨基转移酶/丙氨酸氨基转移酶比值与 2 型糖尿病患者糖尿病肾病的相关性
目的：探讨天冬氨酸氨基转移酶与丙氨酸氨基转移酶比值（AST/ALT）与糖尿病肾病（DN）之间的关系。
患者与方法：将402例2型糖尿病患者分为正常白蛋白尿组（n=196）、微量白蛋白尿组（n=131）和大量白蛋白尿组（n=75）三组。收集基本信息和实验室结果。还测量了血清 AST/ALT、肿瘤坏死因子-α (TNF-α)、白细胞介素 (IL)-2、IL-4、IL-6、IL-10 和干扰素-γ (INF-γ)。DN被定义为微量白蛋白尿或大量白蛋白尿。估计的肾小球滤过率 (eGFR) 使用以下公式计算：186 × (血清肌酐) - 1.154 × (年龄) - 0.203×（如果是女性，则为 0.742）。
结果：大量白蛋白尿组的AST/ALT高于微量白蛋白尿组和正常白蛋白尿组。大量白蛋白尿组肿瘤坏死因子-α（TNF-α）、IL-2、IL-4、IL-10和INF-γ浓度显着高于其他两组。多因素逻辑分析显示，调整混杂因素后，TNF-α和高AST/ALT是DN和大量白蛋白尿的独立风险。此外，AST/ALT 与 TNF-α (r = 0.101, P = 0.048)、IL-4 (r = 0.185, P = 0.005) 和 IL-6 (r = 0.274, P < 0.001) 水平呈显着正相关.
结论：该研究表明，高 AST/ALT 是 DN 的独立危险因素。此外，AST/ALT与炎症细胞因子如TNF-α、IL-4和IL-6水平呈正相关。
关键词： AST/ALT，糖尿病肾病，炎症因子，肿瘤坏死因子-α
更新日期：2021-09-06
Patients and Methods: A total of 402 patients with type 2 diabetes mellitus were divided into three groups, such as normoalbuminuria (n = 196), microalbuminuria (n = 131) and macroalbuminuria (n = 75) groups. Basic information and laboratory results were collected. Serum AST/ALT, tumor necrosis factor-α (TNF-α), interleukin (IL)-2, IL-4, IL-6, IL-10 and interferon- γ (INF- γ) were also measured. DN was defined as microalbuminuria or macroalbuminuria. The estimated glomerular filtration rate (eGFR) was calculated using the following formula: 186 × (serum creatinine)− 1.154× (age)− 0.203× (0.742 if female).
Results: The AST/ALT in the macroalbuminuria group was higher than in the microalbuminuria and normoalbuminuria groups. The concentrations of tumor necrosis factor-α (TNF-α), IL-2, IL-4, IL-10 and INF-γ in the macroalbuminuria group were significantly higher than those in the two other groups. Multivariate logistical analysis showed that after adjusting confounding factors, TNF-α and high AST/ALT were independent risks for DN and macroalbuminuria. Furthermore, the AST/ALT had significantly positive correlation with TNF-α (r = 0.101, P = 0.048), IL-4 (r = 0.185, P = 0.005) and IL-6 (r = 0.274, P < 0.001) levels.
Conclusion: This study showed that high AST/ALT was an independent risk factor for the DN. Additionally, AST/ALT was positively correlated with inflammation cytokines, such as TNF-α, IL-4 and IL-6 levels.
Keywords: AST/ALT, diabetic nephropathy, inflammatory factors, tumor necrosis factor-α
中文翻译：
天冬氨酸氨基转移酶/丙氨酸氨基转移酶比值与 2 型糖尿病患者糖尿病肾病的相关性
目的：探讨天冬氨酸氨基转移酶与丙氨酸氨基转移酶比值（AST/ALT）与糖尿病肾病（DN）之间的关系。
患者与方法：将402例2型糖尿病患者分为正常白蛋白尿组（n=196）、微量白蛋白尿组（n=131）和大量白蛋白尿组（n=75）三组。收集基本信息和实验室结果。还测量了血清 AST/ALT、肿瘤坏死因子-α (TNF-α)、白细胞介素 (IL)-2、IL-4、IL-6、IL-10 和干扰素-γ (INF-γ)。DN被定义为微量白蛋白尿或大量白蛋白尿。估计的肾小球滤过率 (eGFR) 使用以下公式计算：186 × (血清肌酐) - 1.154 × (年龄) - 0.203×（如果是女性，则为 0.742）。
结果：大量白蛋白尿组的AST/ALT高于微量白蛋白尿组和正常白蛋白尿组。大量白蛋白尿组肿瘤坏死因子-α（TNF-α）、IL-2、IL-4、IL-10和INF-γ浓度显着高于其他两组。多因素逻辑分析显示，调整混杂因素后，TNF-α和高AST/ALT是DN和大量白蛋白尿的独立风险。此外，AST/ALT 与 TNF-α (r = 0.101, P = 0.048)、IL-4 (r = 0.185, P = 0.005) 和 IL-6 (r = 0.274, P < 0.001) 水平呈显着正相关.
结论：该研究表明，高 AST/ALT 是 DN 的独立危险因素。此外，AST/ALT与炎症细胞因子如TNF-α、IL-4和IL-6水平呈正相关。
关键词： AST/ALT，糖尿病肾病，炎症因子，肿瘤坏死因子-α
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