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采用倾向评分匹配分析探讨血清肝酶与高血压的关系:来自一项大型库尔德前瞻性队列研究的证据。

Association between serum liver enzymes and hypertension using propensity score matching analysis: evidence from a large kurdish prospective cohort study.

机构信息

Department of Epidemiology, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran.

Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran.

出版信息

BMC Cardiovasc Disord. 2022 Nov 10;22(1):476. doi: 10.1186/s12872-022-02884-3.

Abstract

BACKGROUND

The association between liver enzymes and hypertension (HTN) has been reported in some studies and the findings are inconsistent. This study was conducted to evaluate the association of liver enzymes with HTN among the Iranian Kurdish population.

METHODS

This prospective cohort study was a part of the 5-years (2017-2021) follow-up phase of the Ravansar Non-Communicable Disease (RaNCD) cohort study in Kermanshah province, western Iran.The association between alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glut amyl transferase (GGT), and alkaline phosphatase (ALP) and HTN was investigated by Cox proportional-hazard model (CPHM). We used one-to-one Propensity score matching (PSM) analysis to minimize the effects of confounding factors on the relationship between liver enzymes and HTN .

RESULTS

The full population included a total of 8267 participants. According to PSM, for liver enzyme GGT a total of 3664 participants were analyzed. The results of multivariate CPHM showed there is a relationship between participants with high level of GGT and had a higher risk of HTN (HR 1.34; 95% CI: 1.11-1.63). After PSM analysis, the effect of GGT on HTN remained positive and significant (HR 1.48; 95% CI: 1.22-1.78). The 5-years incidence rate of HTN in men and women were 1.27 and 0.81 (person-year), respectively.GGT had the greatest accuracy, which demonstrated an AUROC of 0.7837.

CONCLUSION

Results of this study showed GGT could be a potential biomarker among liver enzymes for early detection of HTN. Therefore, monitoring GGT levels is helpful in the early detection of HTN.

摘要

背景

一些研究报道了肝酶与高血压(HTN)之间存在关联,但研究结果并不一致。本研究旨在评估伊朗库尔德人群中肝酶与 HTN 的相关性。

方法

本前瞻性队列研究是伊朗西部克尔曼沙赫省拉万萨尔非传染性疾病(RaNCD)队列研究 5 年(2017-2021 年)随访阶段的一部分。采用 Cox 比例风险模型(CPHM)研究丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、γ-谷氨酰转移酶(GGT)和碱性磷酸酶(ALP)与 HTN 的相关性。我们采用一对一倾向评分匹配(PSM)分析来最小化混杂因素对肝酶与 HTN 之间关系的影响。

结果

全人群共纳入 8267 名参与者。根据 PSM,共对肝酶 GGT 进行了 3664 名参与者的分析。多变量 CPHM 结果显示,高水平 GGT 组参与者发生 HTN 的风险较高(HR 1.34;95%CI:1.11-1.63)。经过 PSM 分析后,GGT 对 HTN 的影响仍然为正且显著(HR 1.48;95%CI:1.22-1.78)。男性和女性的 HTN 5 年累积发病率分别为 1.27 和 0.81(人年)。GGT 的准确性最高,AUROC 为 0.7837。

结论

本研究结果表明,GGT 可能是肝酶中预测 HTN 的潜在生物标志物。因此,监测 GGT 水平有助于早期发现 HTN。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b32d/9647908/dd0e1bb73c75/12872_2022_2884_Fig1_HTML.jpg

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