Department of Nephrology, Health Sciences University Ankara Dışkapı Yıldırım Beyazıt Education & Research Hospital, Ankara, Turkey.
Department of Nephrology, Health Sciences University Ankara Gülhane Education & Research Hospital, Ankara, Turkey.
Indian J Med Res. 2022 Mar;155(3&4):397-402. doi: 10.4103/ijmr.IJMR_1777_19.
BACKGROUND & OBJECTIVES: Cardiovascular disease (CVD) remains the leading cause of mortality among patients with chronic kidney disease (CKD). Liver function tests (LFTs) have emerged as markers of CVD risk in some population-based studies. Hence, in the present study the relation between LFTs and biochemical cardiovascular risk factors (CRFs) were evaluated in CKD patients.
A total of 246 patients with stage 3-5 pre-dialysis CKD were enrolled. Demographics, LFTs [alanine aminotransferase (ALT), aspartate aminotransferase (AST) and gamma-glutamyltransferase (GGT)] and biochemical CRFs were recorded retrospectively. Glomerular filtration rate (GFR) was calculated using CKD-EPI equation.
ALT was positively correlated with GFR, albumin, triglyceride and 25-hydroxyvitamin D and negatively correlated with CRP and intact parathyroid hormone (iPTH); AST was positively correlated with GFR, albumin, high-density lipoprotein cholesterol (HDL-C) and 25-hydroxyvitamin D and negatively correlated with CRP and iPTH; GGT was positively correlated with GFR, CRP and triglyceride and negatively correlated with HDL-C. In diabetic patients, ALT correlated positively with GFR; AST correlated positively with GFR and HDL-C, but correlated negatively with iPTH. In the correlation analysis between GFR and CRF, GFR was positively correlated with albumin, triglyceride and 25-hydroxyvitamin D and negatively correlated with CRP, iPTH and albuminuria in both total study population and diabetic group. A partial correlation analysis revealed no correlation between LFTs and CRFs after being controlled for GFR.
INTERPRETATION & CONCLUSIONS: The results of the present study suggest that the relationship between LFTs and biochemical CRFs seems to be a function of impaired GFR.
心血管疾病（CVD）仍然是慢性肾脏病（CKD）患者死亡的主要原因。一些基于人群的研究表明，肝功能检查（LFTs）已成为 CVD 风险的标志物。因此，本研究评估了 CKD 患者的 LFTs 与生化心血管危险因素（CRFs）之间的关系。
共纳入 246 例 3-5 期透析前 CKD 患者。回顾性记录患者的人口统计学资料、LFTs[丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）和γ-谷氨酰转移酶（GGT）]和生化 CRFs。采用 CKD-EPI 方程计算肾小球滤过率（GFR）。
ALT 与 GFR、白蛋白、甘油三酯和 25-羟维生素 D 呈正相关，与 CRP 和全段甲状旁腺激素（iPTH）呈负相关；AST 与 GFR、白蛋白、高密度脂蛋白胆固醇（HDL-C）和 25-羟维生素 D 呈正相关，与 CRP 和 iPTH 呈负相关；GGT 与 GFR、CRP 和甘油三酯呈正相关，与 HDL-C 呈负相关。在糖尿病患者中，ALT 与 GFR 呈正相关；AST 与 GFR 和 HDL-C 呈正相关，与 iPTH 呈负相关。在 GFR 与 CRF 的相关性分析中，GFR 与白蛋白、甘油三酯和 25-羟维生素 D 呈正相关，与 CRP、iPTH 和蛋白尿呈负相关，在总研究人群和糖尿病组中均如此。偏相关分析显示，在控制 GFR 后，LFTs 与 CRFs 之间无相关性。
本研究结果表明，LFTs 与生化 CRFs 之间的关系似乎是 GFR 受损的结果。
