AST/ALT 比值与高血压患者全因和心血管死亡率的关系。

The association between AST/ALT ratio and all-cause and cardiovascular mortality in patients with hypertension.

机构信息

Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China.

Center for Prevention and Treatment of Cardiovascular Diseases, the Second Affiliated Hospital of Nanchang University, Nanchang of Jiangxi, China.

出版信息

Medicine (Baltimore). 2021 Aug 6;100(31):e26693. doi: 10.1097/MD.0000000000026693.

Previous studies had shown that an increased aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT ratio) was associated with cardiovascular disease. This study aimed to assess the relationship between AST/ALT ratio and all-cause and cardiovascular mortality in patients with hypertension.By March 31, 2020, a cohort of 14,220 Chinese hypertensive patients was followed up. The end point was all-cause and cardiovascular death. Hazard ratios (HRs) and 95% CIs were calculated for mortality associated with AST/ALT ratio, using Cox proportional hazards models and competing risk model.In an average of 1.7 years of follow-up, 1.39% (n = 198) of patients died, 55.5% (n = 110) of whom from cardiovascular disease. AST/ALT ratio was associated with increased risk of all-cause death (HR:1.37, 95% CI:1.15-1.63) and cardiovascular death (HR:1.32, 95% CI:1.03-1.68) after adjustment for other potential confounders. Compared with low AST/ALT ratio (Tertile 1), high AST/ALT ratio was associated with high cause mortality (Tertile 2: HR:1.35, 95% CI:0.86-2.10; Tertile 3: HR:2.10, 95% CI:1.37-3.21; P for trend <.001). Compared with low AST/ALT ratio (Tertile 1), a statistically significant increased risk of cardiovascular mortality was also observed (Tertile 2: HR:1.27, 95% CI:0.70-2.29; Tertile 3: HR:1.92, 95% CI:1.09-3.37; P for trend <.001). High AST/ALT ratio was also associated with high cardiovascular mortality (Tertile 2: HR:1.27, 95% CI:0.70-2.29; Tertile 3: HR:1.92, 95% CI:1.09-3.37; P for trend <.001).Present study indicated that increased AST/ALT ratio levels were predictive of all-cause and cardiovascular mortality among Chinese hypertensive patients.Trial registration: CHICTR, CHiCTR1800017274. Registered 20 July 2018.

先前的研究表明，天门冬氨酸氨基转移酶与丙氨酸氨基转移酶比值（AST/ALT 比值）的升高与心血管疾病有关。本研究旨在评估高血压患者 AST/ALT 比值与全因和心血管死亡率之间的关系。

截至 2020 年 3 月 31 日，对 14220 名中国高血压患者进行了队列研究。终点为全因和心血管死亡。使用 Cox 比例风险模型和竞争风险模型计算与 AST/ALT 比值相关的死亡率的风险比（HR）和 95%置信区间（CI）。

在平均 1.7 年的随访中，有 1.39%（n=198）的患者死亡，其中 55.5%（n=110）死于心血管疾病。AST/ALT 比值与全因死亡风险增加相关（HR：1.37，95%CI：1.15-1.63）和心血管死亡（HR：1.32，95%CI：1.03-1.68），在调整其他潜在混杂因素后。与低 AST/ALT 比值（三分位 1）相比，高 AST/ALT 比值与高原因死亡率相关（三分位 2：HR：1.35，95%CI：0.86-2.10；三分位 3：HR：2.10，95%CI：1.37-3.21；趋势 P<.001）。与低 AST/ALT 比值（三分位 1）相比，也观察到心血管死亡率显著增加的风险（三分位 2：HR：1.27，95%CI：0.70-2.29；三分位 3：HR：1.92，95%CI：1.09-3.37；趋势 P<.001）。高 AST/ALT 比值也与高心血管死亡率相关（三分位 2：HR：1.27，95%CI：0.70-2.29；三分位 3：HR：1.92，95%CI：1.09-3.37；趋势 P<.001）。

本研究表明，AST/ALT 比值升高可预测中国高血压患者的全因和心血管死亡率。