ABSTRACT
Objective:To investigate the relationship between liver function and arterial stiffness in the physical examination population.Methods:A total of 9 111 people who received physical examination in the Health Management Center of Wuhan Tongji Hospital from January to December 2017 with an age of 18 and above and complete clinical data were included in this study. The subjects were divided into arterial stiffness group (3 252 cases) and the normal group (5 859 cases) according to the results of brachial-ankle artery pulse wave velocity (baPWV) examination. The liver function indicators were checked in all the subjects, including alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and glutamyl transpeptidase γ (GGT). According to interquartile range of the liver function indicators, the subjects were divided into 4 groups (group Q1- Q4). Multivariate logistic regression analysis and restricted cubic spline functions were used to explore the relationship between liver function and risk of arterial stiffness. Results:When the subjects were grouped by ALT, after adjusted for age and gender, the risk of arterial stiffness in the Q2 to Q4 groups was 1.260 (95% CI:1.093-1.452, P<0.05), 1.571 (95% CI:1.355-1.822, P<0.001) and 2.436 (95% CI:2.097-2.830, P<0.001) times of that in the Q1 group, respectively, P for trend<0.001. And after adjusted for age, gender, body mass index, low-density lipoprotein cholesterol (LDL-C), triglycerides, high-density lipoprotein cholesterol (HDL-C), the risk of arterial stiffness in the Q2 to Q4 groups was 1.158 (95% CI:1.003-1.338, P<0.05), 1.331 (95% CI:1.143-1.551, P<0.001) and 1.867 (95% CI:1.591-2.190, P<0.001) times of that in the Q1 group, respectively, P for trend <0.001. After adjusted for age, gender, body mass index, LDL-C, triglycerides, HDL-C, systolic blood pressure, diastolic blood pressure, heart rate, fasting blood glucose, blood uric acid, serum creatinine, with or without hypertension or diabetes, the risk of arterial stiffness in the Q2 to Q4 groups was 1.116 (95% CI:0.940-1.325, P=0.210), 1.241 (95% CI:1.036-1.488, P<0.05) and 1.598 (95% CI:1.322-1.932, P<0.001) times of that in the Q1 group, respectively, P for trend <0.001. Restricted cubic spline regression analysis showed a linear positive correlation between ALT and the risk of arterial stiffness. Similar results as ALT obtained with AST, ALP and GGT. Conclusions:The increase of liver function indicators is positively correlated with the risk of arterial stiffness.
ABSTRACT
Objective To evaluate the association between aortic arterial stiffness and target organ damage, including renal function decline and left ventricular diastolic dysfunction among elderly diabetic patients and to provide theoretical basis for early prevention and intervention. Methods Brachial-ankle-artery pulse wave velocity(baPWV)reflecting aortic arterial stiffness was observed in 151 diabetic patients with(n=78)or without hypertension(n=73). Clinical data were collected, cardiac structure and function were assessed by echocardiography. Estimated glomerular filtration rate(eGFR)was calculated by CKD-EPI fomula. Results Of 151 subjects, the average age was(75.05±10.13)years and the average baPWV values was (1 803.85±491.04)mm/s. Patients with both diabetes and hypertension had significantly higher baPWV values[(2006.49± 536.70)mm/s]than that of diabetic patients[(1596.96 ±331.02)mm/s, P<0.01]. Multiple linear regression analysis demonstrated that baPWV was negatively associated with E/A ratio and eGFR(β'=-0.249, -0.225, P<0.05), but positively associated with hypertension(β'=2.008, P<0.05). By applying area under the receiver operator characteristic curve, baPWV had powerful predictive power for renal impairment(AUC=0.695, 95% CI: 0.548-0.842)and left ventricular diastolic dysfunction(AUC=0.687, 95%CI: 0.532-0.842). Conclusion Patients with both diabetes and hypertension had significantly higher baPWV values than that of diabetic patients. Higher baPWV was independently associated with greater burden of sub-clinical disease in renal impairment and left ventricular diastolic dysfunction.