高中生丙胺酸轉胺酶、血小板與血糖偏高之相關

Associations among Elevated Alanine Transaminase,Platelet Count, and Hyperglycemia in High School Students

目的：過去研究發現丙胺酸轉胺酶（ALT）升高可預測新發生的糖尿病，而胰島素阻抗會引起血小板過度活化，導致血小板數目上升。本研究目的為了解某市高中一年級學生ALT及空腹血糖狀況，以及ALT、血小板與血糖偏高的相關性。
方法：橫斷面研究，納入2023年某市之年齡滿15歲未滿16歲的學生。變項有性別、ALT、血壓、空腹血糖、高密度脂蛋白膽固醇、低密度脂蛋白膽固醇、三酸甘油酯、尿酸、肌酸酐、血小板。以多變項邏輯斯迴歸分析ALT、血小板與血糖偏高的關聯。
結果：排除B肝帶原者，納入26，278人，男性有14，104人（53.7％）。血糖偏高（100mg／dL）者有619人（2.4％），包括血糖介於100-125有555人（2.1％），血糖超過126有64人（0.24％）。ALT分成四組（ALT£20、21£ALT£42、43£ALT£84、ALT>84）。與ALT£20相比，各組ALT與血糖偏高的勝算比（OR）及95％CI分別是1.29（1.01-1.66）、2.19（1.52-3.14）、3.73（2.37-5.86）。血小板數在第三分位與第四分位者，與第一分位者相比較，血糖偏高的OR及95％CI分別是1.33（1.03-1.71）及1.82（1.43-2.32）。
結論：即使在參考值範圍內，ALT升高或是血小板數升高與血糖偏高有相關。建議ALT或是血小板偏高之學生調適生活方式、養成健康生活型態，如規律運動、均衡飲食及避免飲酒過量，並定期追蹤檢查。

Purpose: Previous studies have shown that elevated alanine aminotransferase (ALT) levels can predict the development of new-onset diabetes. Insulin resistance can cause excessive platelet activation, leading to an increase in platelet count. This study aimed to investigate ALT and fasting blood glucose levels among first-year high school students in a city in Taiwan, and to examine the associations among ALT, platelet count, and hyperglycemia.
Methods: This cross-sectional study enrolled students aged 15 to under 16 years in a city in 2023. The variables included sex, ALT, blood pressure, fasting blood glucose, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, uric acid, creatinine, and platelet count. Multivariate logistic regression was used to analyze the associations among ALT, platelet count, and elevated blood glucose.
Results: With hepatitis B carriers excluded, 26,278 individuals were included, of whom 14,104 (53.7%) were male. Hyperglycemia (fasting blood glucose≥100 mg/dL) was observed in 619 individuals (2.4%), including 555 (2.1%) with a blood glucose level between 100 and 125 md/dL, and 64 (0.24%) with a blood sugar level exceeding 126 mg/dL. ALT levels were categorized into four groups (ALT≤20, 21≤ALT≤42, 43≤ALT≤84, and ALT >84). Compared with ALT≤20 group, the odds ratios (ORs) and 95% confidence intervals (CIs) for hyperglycemia in the remaining groups were 1.29 (1.01-1.66), 2.19 (1.52-3.14), and 3.73 (2.37-5.86), respectively. Compared with those in the first quartile, participants in the third and fourth quartiles of platelet count reported ORs (95% CIs) for hyperglycemia of 1.33 (1.03-1.71) and 1.82 (1.43-2.32), respectively.
Conclusion: Even within the reference range, elevated ALT or platelet count is associated with elevated blood glucose. Students with elevated ALT levels or platelet counts are advised to adopt healthy lifestyle habits, including regular exercise, a balanced diet, and avoidance of excessive alcohol consumption. Regular follow-up monitoring is also recommended.