Elevated GOT/GPT Ratio is Negatively Correlated With Trabecular Bone Score and Implicated for Deterioration of Bone Strength

Background: Many studies indicated that the liver disease, like viral liver disease, alcohol liver disease, non-alcoholic fatty liver disease, is the risk of osteoporosis. However, the bone tissue is constructed by cortical bone and trabecular bone, while most of the weight bearing depends on the trabecular bone. The trabecular bone score (TBS) could be used as a substitute for bone microstructure to infer the strength of the skeleton. This retrospective study aimed to use the glutamic-oxaloacetic transaminase/glutamic-pyruvic transaminase (GOT/GPT) ratio and TBS to further explore the relationship between the liver damage and bone strength. Methods: Data were collected from subjects attending a regional hospital, from February 2019 to February 2020. Those subjects with hepatitis B virus, hepatitis C virus, a history of drinking and a GOT value ＞ 40 U/L were excluded by the figure of diagnose liver disease types. Univariate and multivariate linear regression analyses were used to determine the association between the GOT/ GPT ratio and TBS. The associations of lumbar spine or hip bone mineral density with TBS, and the related factors with the GOT/GPT ratio were evaluated by univariate linear regression analysis. Results: 1,793 subjects were included, with a mean age of 58.0 ± 11.1 years old, GOT/GPT ratio 0.80 ± 0.24, and TBS 1.329 ± 0.108. Univariate linear regression analysis showed that the GOT/GPT ratio was negatively correlated with TBS (r = -0.117, p ＜ 0.001). In multivariate linear regression analysis, the GOT/GPT ratio was also negatively correlated with TBS (r = -0.141, p ＜ 0.001). Conclusion: Our results showed that the TBS was significantly negatively correlated with the GOT/GPT ratio. Therefore, for cases with the liver damage should also check up for their skeletal health.

關鍵字

glutamic-oxaloacetic transaminase (GOT) ； GOT/GPT ratio ； glutamic-pyruvic transaminase (GPT) ； trabecular bone score (TBS)

並列摘要

背景：許多研究顯示肝臟疾病，如病毒性肝病、酒精性肝病、非酒精性脂肪性肝病，皆會增加罹患骨質疏鬆症的風險。骨骼是由皮質骨和小梁骨構成的，而大部分的負重取決於小梁骨。骨小梁分數（trabecular bone score, TBS）可作為骨微觀結構的替代物來推斷骨骼的強度。本回溯性研究旨在利用glutamic-oxaloacetic transaminase/glutamic-pyruvic transaminase（GOT/GPT）比率和TBS進一步探討肝損傷與骨強度之間的關係。方法：本篇研究數據收集自2019年2月至2020年2月位於一間地區醫院接受健康檢查的病患。依據診斷肝病類型圖，我們排除了患有B型肝炎、C型肝炎、飲酒史和GOT數值大於40 U/L的受試者。採用單變量和多變量線性回歸，分析GOT/GPT比率與TBS之間的關聯。並採用單變量線性回歸分析TBS分別與腰椎、股骨頸和總髖骨BMD的關係；以及同樣透過單變量線性回歸分析GOT/GPT比率與相關因子。結果：共納入1,793名受試者，平均年齡58.0 ± 11.1歲，GOT/GPT比率為0.80 ± 0.24，TBS為1.329 ± 0.108。單變量線性回歸分析顯示GOT/GPT比率與TBS呈現負相關（r = -0.117，p ＜ 0.001）。並在多變量線性回歸分析中，GOT/GPT比率也與TBS呈現負相關（r = -0.141，p ＜ 0.001）。結論：我們的結果顯示TBS與GOT/GPT比率呈顯著負相關。因此肝臟受損的患者除了留意本身的肝臟健康外，還需留意其骨骼的健康。

並列關鍵字

天門冬胺酸轉胺酶；丙胺酸轉胺酶； GOT/GPT比率；骨小樑分數

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