The association between serum alanine aminotransferase and hypertension: A national based cross-sectional analysis among over 21 million Chinese adults

Abstract

Background Inconsistent results were found in the association between serum alanine aminotransferase (ALT) and hypertension among population-based studies. This study evaluated the association between ALT and hypertension among Chinese reproductive-age population by utilizing registration data from National Free Pre-pregnancy Checkups Project in 2016–2017. Methods The 21,103,790 registered participants were eligible for analysis, including women who were 20–49 years old and men who were 20–59 years old with available data for ALT and blood pressure (BP). Logistic regression was conducted to estimate odds ratio (OR) for the association between ALT and hypertension as a binary outcome. Linear regression was used to examine the association between ALT and BP as a continuous outcome. Results In total, 4.21% of the participants were hypertensive, and 11.67% had elevated ALT (> 40 U/L). Hypertension prevalence was 3.63% and 8.56% among participants with normal and elevated ALT levels. A strong linear relationship was found between serum ALT levels and the odds of hypertension after adjustment for potential confounders. The multivariable-adjusted ORs for hypertension were 1, 1.22 (1.21, 1.22), 1.67 (1.65 1.68), 1.78 (1.76, 1.80), and 1.92 (1.90, 1.94) in participants with ALT levels of ≤ 20, 20.01–40, 40.01–60, 60.01–80, and > 80 U/L, respectively. Systolic and diastolic BPs rose by 1.83 and 1.20 mmHg on average, for each 20 U/L increase in ALT (P for trend < 0.001). The association was consistent among subgroups and tended to be stronger among populations who are overweight (body mass index ≥ 24 kg/m2) (χ2 = 52,228, P < 0.001), alcohol drinking (χ2 = 100,730, P < 0.001) and cigarette smoking (χ2 = 105,347, P < 0.001). Conclusions Our cross-sectional analysis suggested a linear association between serum ALT and hypertension or BP, which indicated that abnormal liver metabolism marked by elevated serum ALT could play a role in hypertension or elevated BP condition.

Evaluation of Relationship between Serum Liver Enzymes and Hypertension: A Cross-Sectional Study Based on Data from Rafsanjan Cohort Study

“…For GGT, in the highest quartile group compared with the lowest quartile, the multivariate-adjusted OR for hypertension was 2.29 (1.68–3.14) in males and 1.52 (1.27–1.83) in females [ 3 ]. In agreement with the results of our study, some previous studies also showed that increased levels of ALP [ 10 – 12 ], GGT [ 8 , 10 ], ALT [ 10 , 25 , 26 ], and AST [ 25 , 27 ] within the normal range are associated with the odds of hypertension. For early detection of nonliver-related disorders such as hypertension, it seems logical that the cutoff level of serum ALT, AST, GGT, and ALP concentrations is modified at a lower level.…”

Effects of dietary supplementation with itaconic acid on the growth performance, nutrient digestibility, slaughter variables, blood biochemical parameters, and intestinal morphology of broiler chickens

“…In this study, dietary IA supplementation significantly increased SOD and CAT contents in the serum at d 1 to 21 and T-AOC at d 22 to 42, indicating that IA can help reduce oxidative stress. Aminotransferases, including ALT and AST, are well-known markers for liver injury ( Jia et al, 2021 ). A growing body of evidence strongly suggests that higher serum ALT or AST levels are substantially correlated with increased liver fat accumulation and excessive inflammation ( Feng et al, 2020 ).…”

Establishment and Evaluation of a Risk-prediction Model for HBP in Elderly Patients With NAFLD From a Health Management Perspective

“…The population in our study was mainly composed of patients with NAFLD, so the predictor ALT is included. A few studies have explored the association between ALT and HBP development, with equally few studies demonstrating association between ALT and HBP [53,54,55] . One of the cross-sectional studies conducted in Chinese adults suggested a positive linear correlation between ALT and HBP development.…”