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山东沿海地区非酒精性脂肪性肝病患者血清ALT、AST、GGT和ALP与血压的相关性分析

刘怡静 赵真真 刘守胜 徐艳艳 辛永宁

刘怡静,赵真真,刘守胜,等. 山东沿海地区非酒精性脂肪性肝病患者血清ALT、AST、GGT和ALP与血压的相关性分析[J]. 临床肝胆病杂志, 2021, 37(9): 2144-2147. DOI: 10.3969/j.issn.1001-5256.2021.09.027
引用本文: 刘怡静,赵真真,刘守胜,等. 山东沿海地区非酒精性脂肪性肝病患者血清ALT、AST、GGT和ALP与血压的相关性分析[J]. 临床肝胆病杂志, 2021, 37(9): 2144-2147. DOI: 10.3969/j.issn.1001-5256.2021.09.027
LIU YJ, ZHAO ZZ, LIU SS, et al. Correlation of serum alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, and alkaline phosphatase with blood pressure in patients with nonalcoholic fatty liver disease in coastal regions of Shandong Province in China[J]. J Clin Hepatol, 2021, 37(9): 2144-2147. DOI: 10.3969/j.issn.1001-5256.2021.09.027
Citation: LIU YJ, ZHAO ZZ, LIU SS, et al. Correlation of serum alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, and alkaline phosphatase with blood pressure in patients with nonalcoholic fatty liver disease in coastal regions of Shandong Province in China[J]. J Clin Hepatol, 2021, 37(9): 2144-2147. DOI: 10.3969/j.issn.1001-5256.2021.09.027

山东沿海地区非酒精性脂肪性肝病患者血清ALT、AST、GGT和ALP与血压的相关性分析

DOI: 10.3969/j.issn.1001-5256.2021.09.027
基金项目: 

国家自然科学基金 31770837

详细信息
    通讯作者:

    辛永宁,xinyongning@163.com

  • 中图分类号: R575.5

Correlation of serum alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, and alkaline phosphatase with blood pressure in patients with nonalcoholic fatty liver disease in coastal regions of Shandong Province in China

Funds: 

National Natural Science Foundation of China 31770837

  • 摘要:   目的  探讨山东沿海地区非酒精性脂肪性肝病(NAFLD)患者血清肝酶水平与血压水平是否存在相关性。  方法  随机选取2019年12月—2020年6月在青岛市市立医院就诊或接受体格检查,长期居住于山东沿海地区的269例NAFLD患者,其中105例患有高血压(高血压组),164例未患高血压(非高血压组)。测量受试者的晨起血压值,计算平均动脉压(MAP);实验室检测受试者血清肝酶(ALT、AST、GGT和ALP)水平及空腹血糖(FBG)。符合正态分布的计量资料2组间比较采用独立样本t检验,不符合正态分布的计量资料2组间比较采用Mann-Whitney U检验。计数资料2组间比较采用χ2检验。应用Pearson相关分析4种肝酶与MAP等指标之间的相关性,应用二元logistic回归模型分析血清肝酶对高血压的影响程度。  结果  高血压组的BMI、MAP和GGT均明显高于非高血压组(P值均 < 0.05)。在总NAFLD患者和非高血压NAFLD患者中,男性的BMI、MAP、ALT、AST、GGT均显著高于女性(P值均 < 0.05),在NAFLD伴高血压组中,男性的GGT水平显著高于女性(P < 0.05)。NAFLD伴高血压组超出正常范围的GGT人数比例高于非高血压组(χ2=4.781, P=0.029)。血清GGT水平与正常范围内的MAP(70~105 mm Hg)有相关性(r=0.178, P=0.011),MAP超出正常范围时,相关性无统计学意义(P=0.415)。应用二元logistic回归模型校正年龄和性别后,NAFLD人群中AST水平与高血压存在正关联(OR=1.011, 95%CI: 1.000~1.022, P=0.040);在此基础上进一步校正BMI和FBG,结果显示NAFLD人群中AST水平仍与高血压存在正关联(OR=1.011, 95%CI: 1.000~1.022, P=0.044)。  结论  在山东沿海地区NAFLD人群中,AST水平增高可能预示着高血压患病风险增加。

     

  • 表  1  不同性别NAFLD患者的临床特征

    指标 总受试者(n=269) 高血压组(n=105) 非高血压组(n=164)
    男(n=187) 女(n=82) 男(n=78) 女(n=27) 男(n=109) 女(n=55)
    年龄(岁) 46.0(42.0~61.0) 47.5(39.0~63.0) 46.0(42.0~62.0) 59.0(46.0~64.0) 47.0(41.5~60.5) 44.0(36.0~61.0)
    BMI(kg/m2) 26.03(24.51~27.68) 25.36(23.41~27.46) 1) 26.37(24.79~28.47) 27.18(24.01~29.13) 25.95(24.20~27.46) 25.15(23.23~26.35)1)
    FBG(mmol/L) 4.98(4.58~5.60) 5.09(4.57~5.82) 5.01(4.51~5.57) 5.42(4.74~6.49) 4.98(4.60~ 5.76) 4.99(4.44~5.54)
    MAP(mm Hg) 100.00(93.33~105.67) 96.67(86.67~103.33)1) 106.67(103.33~110.75) 107.33(103.33~113.33) 93.33(88.34~97.33) 90.00(83.33~97.00)1)
    ALT(U/L) 27.27(19.54~45.63) 18.84(15.38~27.86)1) 26.61(18.08~46.19) 21.67(16.63~32.52) 27.60(20.11~41.55) 17.83(14.93~23.62)1)
    AST(U/L) 23.25(18.38~33.36) 20.01(16.25~24.88)1) 22.11(18.44~33.45) 23.54(19.91~27.04) 23.43(18.26~31.20) 18.89(15.93~23.76)1)
    GGT(U/L) 33.65(22.76~48.42) 21.81(16.16~30.59)1) 37.14(26.67~53.84) 28.30(20.15~43.68)1) 30.81(22.19~45.42) 19.87(15.73~26.62)1)
    ALP(U/L) 76.10(62.57~88.48) 77.95(64.06~96.19) 76.83(62.15~87.69) 78.70(68.67~91.52) 75.61(62.98~90.33) 75.68(61.41~98.01)
    注:与同组男性比较,1)P < 0.05。
    下载: 导出CSV

    表  2  伴高血压NAFLD与非高血压NAFLD患者血清肝酶情况比较

    指标 高血压组(n=105) 非高血压组(n=164) χ2 P
    ALT[例(%)] 2.634 0.268
        低于正常 0 2(1.2)
        正常 82(78.1) 133(81.1)
        高于正常 23(21.9) 29(17.7)
    AST[例(%)] 1.193 0.551
        低于正常 4(3.8) 8(4.9)
        正常 91(86.7) 134(81.7)
        高于正常 10(9.5) 22(13.4)
    GGT[例(%)] 4.781 0.029
        低于正常 0 0
        正常 73(69.5) 133(81.1)
        高于正常 32(30.5) 31(18.9)
    ALP[例(%)] 0.644 0.725
        低于正常 5(4.8) 5(3.0)
        正常 96(91.4) 154(93.9)
        高于正常 4(3.8) 5(3.0)
    下载: 导出CSV

    表  3  血清肝酶与MAP及部分高血压危险因素的相关性分析

    指标 ALT AST GGT ALP
    r P r P r P r P
    MAP -0.003 0.958 0.029 0.633 0.146 0.016 0.045 0.459
        70 mm Hg≤MAP≤105 mm Hg -0.037 0.603 0.025 0.721 0.178 0.011 0.078 0.271
        MAP>105 mm Hg 0.065 0.603 0.049 0.696 0.102 0.415 0.193 0.121
    年龄 -0.231 <0.001 -0.057 0.349 -0.080 0.189 0.308 <0.001
    BMI 0.264 <0.001 0.147 0.016 0.276 <0.001 -0.102 0.096
    FBG 0.025 0.690 -0.007 0.912 0.069 0.261 0.181 0.003
    下载: 导出CSV
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  • 收稿日期:  2021-02-22
  • 修回日期:  2021-03-10
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