血清转氨酶水平升高与慢性肾脏病指标的相关性：西班牙裔社区健康研究/拉丁裔研究。

Association of elevated serum aminotransferase levels with chronic kidney disease measures: hispanic community health study/study of latinos.

机构信息

Institute for Minority Health Research, University of Illinois at Chicago, 1819 W Polk St, Ste 246, IL, 60612, Chicago, USA.

Department of Medicine, Division of Nephrology and Hypertension, Loyola University Chicago Health Sciences Campus, IL, Maywood, USA.

出版信息

BMC Nephrol. 2021 Sep 7;22(1):302. doi: 10.1186/s12882-021-02483-y.

DOI:10.1186/s12882-021-02483-y

PMID:34493216

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8422630/

Abstract

BACKGROUND

Previous studies have shown an association between non-alcoholic fatty liver disease (NAFLD) and chronic kidney disease (CKD), but it is unclear whether the association is independent of metabolic syndrome.

METHODS

Data from 13,006 participants aged 18 to 74 years in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) without viral hepatitis, excessive alcohol consumption, or high transferrin saturation levels were analyzed. Suspected NAFLD was defined as presence of sex-specific elevations in serum aminotransferase levels (aspartate aminotransferase (AST) > 37 U/L or alanine aminotransferase (ALT) > 40 U/L for men and AST or ALT > 31 U/L for women). Logistic regression was used to examine cross-sectional associations of elevated serum aminotransferase levels with low estimated glomerular filtration rate (eGFR < 60 ml/min/1.73 m based on cystatin C), and with high urinary albumin-to-creatinine ratio (UACR) (> 17 mg/g in men and > 25 mg/ g in women) in separate models adjusting for demographic characteristics and metabolic syndrome.

RESULTS

Mean (SD) age was 41 (0.27) years, and 45 % were male. Elevated serum aminotransferase levels were noted in 18.8 % of the population and were associated with greater odds of high UACR (OR = 1.31; 95 % CI = 1.10, 1.56) after adjusting for demographic characteristics; this association became non-significant after adjustment for metabolic syndrome (OR = 1.11, 95 % CI = 0.92, 1.33). In contrast, elevated serum aminotransferase levels were not associated with low eGFR (odds ratio (OR) = 0.73; 95 % confidence interval (CI) = 0.45, 1.18) after adjusting for covariates.

CONCLUSIONS

In this sample of diverse U.S. Hispanic Latino adults, elevated serum aminotransferase levels were not independently associated with measures of CKD.

摘要

背景

先前的研究表明，非酒精性脂肪性肝病（NAFLD）与慢性肾脏病（CKD）之间存在关联，但尚不清楚这种关联是否独立于代谢综合征。

方法

分析了 13006 名年龄在 18 至 74 岁之间的西班牙裔社区健康研究/拉丁裔研究（HCHS/SOL）参与者的数据，这些参与者无病毒性肝炎、过量饮酒或高铁蛋白饱和度水平。疑似 NAFLD 的定义为血清转氨酶水平升高（男性天门冬氨酸氨基转移酶（AST）>37 U/L 或丙氨酸氨基转移酶（ALT）>40 U/L，女性 AST 或 ALT>31 U/L）。使用逻辑回归检查血清转氨酶水平升高与肾小球滤过率估计值降低（基于胱抑素 C，<60 ml/min/1.73 m）和高尿白蛋白/肌酐比（UACR）（男性>17mg/g，女性>25mg/g）之间的横断面关联，分别在调整人口统计学特征和代谢综合征的单独模型中进行。

结果

平均（SD）年龄为 41（0.27）岁，45%为男性。人群中 18.8%存在血清转氨酶水平升高，调整人口统计学特征后，该水平升高与 UACR 升高的比值比（OR）为 1.31（95%CI=1.10, 1.56）；调整代谢综合征后，这种关联变得无统计学意义（OR=1.11，95%CI=0.92，1.33）。相比之下，调整协变量后，血清转氨酶水平升高与 eGFR 降低无关（比值比（OR）=0.73；95%置信区间（CI）=0.45，1.18）。