Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand.
Department of Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand.
BMC Cardiovasc Disord. 2023 Mar 21;23(1):143. doi: 10.1186/s12872-023-03181-3.
The relationship between hypertension (HT) and serum liver enzymes was reported in a few studies, but the findings were inconsistent. Therefore, the present study aimed to identify the association between elevated serum liver enzymes and raised BP through the use of a large sample of Royal Thai Army (RTA) personnel.
The dataset obtained from the annual health examination database of RTA personnel in Thailand was utilized. A total of 244,281 RTA personnel aged 35-60 were included in the current study. Elevated serum liver enzymes were defined as aspartate aminotransferase (AST) or alanine aminotransferase (ALT) ≥ 40 U/L in males and ≥ 35 U/L in females. HT was defined as systolic BP ≥ 140 or diastolic BP ≥ 90 mmHg. A multivariable linear regression model was used to estimate the coefficient and 95% confidence intervals (CI), whereas a multivariable logistic regression model was applied to estimate adjusted odds ratios (AORs) and 95% CI for the association between raised BP and serum liver enzymes.
Compared to individuals with SBP < 120 and DBP < 80 mmHg, the β coefficients of log-transformed AST and ALT were 0.13 (95% CI: 0.12-0.13) and 0.11 (95% CI: 0.11-0.12) in males with HT. Meanwhile, the β coefficients of log-transformed AST and ALT were 0.03 (95% CI: 0.02-0.04) and 0.07 (95% CI: 0.05-0.08) in females with HT. In males, HT was associated with elevated AST (AOR: 1.92; 95% CI: 1.85-2.01) and elevated ALT (AOR: 1.43; 95% CI: 1.38-1.48). On the other hand, in females, HT was associated with elevated AST (AOR: 1.42; 95% CI: 1.21-1.66) and elevated ALT (AOR: 1.38; 95% CI: 1.21-1.57).
Raised BP was positively correlated with elevated AST and ALT in active-duty RTA personnel. Moreover, HT was independently attributed to higher odds of elevated AST and ALT in comparison to optimal BP in both males and females. Furthermore, the relationship between serum liver enzymes and BP was modified by sex.
已有少数研究报道了高血压（HT）与血清肝酶之间的关系，但研究结果并不一致。因此，本研究旨在通过利用大量泰国皇家陆军（RTA）人员的数据，确定升高的血清肝酶与升高的血压之间的关联。
本研究使用了来自泰国 RTA 人员年度健康检查数据库的数据。共纳入了 244281 名年龄在 35-60 岁的 RTA 人员。血清肝酶升高定义为男性天门冬氨酸氨基转移酶（AST）或丙氨酸氨基转移酶（ALT）≥40 U/L，女性 AST 或 ALT≥35 U/L。HT 定义为收缩压≥140 或舒张压≥90mmHg。使用多变量线性回归模型估计系数和 95%置信区间（CI），使用多变量逻辑回归模型估计升高的血压与血清肝酶之间的关联的调整比值比（AOR）和 95%CI。
与收缩压<120mmHg 和舒张压<80mmHg 的个体相比，男性 HT 患者 AST 和 ALT 的对数变换β系数分别为 0.13（95%CI：0.12-0.13）和 0.11（95%CI：0.11-0.12）。同时，女性 HT 患者 AST 和 ALT 的对数变换β系数分别为 0.03（95%CI：0.02-0.04）和 0.07（95%CI：0.05-0.08）。在男性中，HT 与 AST 升高（AOR：1.92；95%CI：1.85-2.01）和 ALT 升高（AOR：1.43；95%CI：1.38-1.48）相关。另一方面，在女性中，HT 与 AST 升高（AOR：1.42；95%CI：1.21-1.66）和 ALT 升高（AOR：1.38；95%CI：1.21-1.57）相关。
现役 RTA 人员中，升高的血压与 AST 和 ALT 升高呈正相关。此外，与最佳血压相比，HT 独立导致男性和女性 AST 和 ALT 升高的几率更高。此外，血清肝酶与血压之间的关系受性别影响。
