中老年人血清转氨酶水平与高血压风险的相关性分析  

The Relationship of Aminotransferase with Incident Hypertension in Middle-Aged and Elderly Chinese

作　　者：陆培培[1,2] 孟旭 王淑玉[2] 东黎光 张宇清 胡爱华[2] 马丽红[1] 周宪梁 王文[1,2] 刘力生[1,2] LU Peipei;MENG Xu;WANG Shuyu;DONG Liguang;ZHANG Yuqing;HU Aihua;MA Lihong;ZHOU Xianliang;WANG Wen;LIU Lisheng(Fuwai Hospital,Chinese Academy of Medical Science,Peking Union Medical College,Beijing 100037,China;Beijing Hypertension League Institute,Chinese Hypertension League)

机构地区：[1]中国医学科学院/北京协和医学院/阜外医院,北京100037 [2]北京市石景山区高血压联盟研究所 [3]北京大学首钢医院

出　　处：《中西医结合心脑血管病杂志》2019年第8期1130-1132,共3页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：国家重点研发计划重大慢性非传染性疾病防控研究重点专项项目(No.2016YFC1300100)

摘　　要：目的分析社区中老年人群血清转氨酶水平与远期高血压发病风险的相关性,为高血压的预防提供依据。方法采用前瞻性观察研究方法,整群抽取来自北京市石景山区古城社区和苹果园社区40岁及以上居民作为调查对象,共9 577例完成基线和3年后的随访调查。采用标准问卷法收集人群的一般情况和临床资料,同时进行体格检查和采集空腹血标本,采用多因素Logistic回归分析转氨酶与高血压的相关关系。结果高血压组年龄、体质指数(BMI)、血压、三酰甘油、空腹血糖和丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)均高于血压正常组,差异有统计学意义(P<0.01)。随访3年,952例(21.5%)发现新发高血压,且新发高血压发病率随着ALT升高而增加。多因素Logistic回归分析结果显示,基线Log_(ALT)与新发高血压呈正相关关系,差异有统计学意义(优势比=1.49,P=0.04)。结论中老年血清ALT水平升高不仅是肝脏损伤表现,反映未来高血压患病风险,同时有利于预防高血压,及早发现高血压,防止高血压并发症的发生,具有重要临床意义。Objective To study the relationship between serum transaminase levels and the risk of incident hypertension in a community-based middle-aged and elderly Chinese cohort. Methods The study was a prospective observational design conducted in the Gucheng and Pingguoyuan communities of Shijingshan district in Beijing. Individuals over 40 years old were eligible to participate in the study. A total of 9 577 persons had the complete baseline and 3-year follow-up data,the sociodemographic information,lifestyle behaviors,and medical history were collected by a standard questionnaire. Anthropometric measurements and fasting blood sample were taken based on the trial operating protocol. Multivariate Logistic regression was used to estimate the associations between incident hypertension and aminotransferase levels. Results At the baseline,age,body mass index,blood pressure,triglyceride,fasting blood glucose,alanine aminotransferase (ALT),and aspartate aminotransferase (AST) in the hypertensive group were higher than those in the normotensive group ( P <0.01). At 3 years of follow-up,952 (21.5%) had incident hypertension,which was positively related with increased ALT. After multivariable adjustment,logistic regression analysis showed that there was a positive correlation between baseline Log ALT and incident hypertension (odds ratio=1.49, P =0.04). Conclusion Elevated serum ALT is not just a biomarker of liver injury,but it is an independent predictor of the risk of hypertension,which is a clinical importance to prevent its progression and subsequent serious hypertension-related complications.

关 键 词：高血压 丙氨酸氨基转移酶 天门冬氨酸氨基转移酶 

分 类 号：R544.1[医药卫生—心血管疾病] R255.3[医药卫生—内科学]