The association of liver enzymes with systolic and diastolic blood pressure in young adults

Abstract

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Science and Technology Department, Brazilian Ministry of Health. Introduction Nonalcoholic fatty liver (NAFLD) disease has been associated with metabolic syndrome and cardiovascular risk factors including cholesterol, type 2 diabetes, obesity, and hypertension. Patients with NAFLD also have increased risk of coronary artery disease and major adverse cardiovascular events. Purpose The aim of this study was to assess the associations of liver enzymes with systolic and diastolic blood pressure in 22-year-old individuals from a 1993 birth cohort in Brazil. Methods During 1993, all live born babies in the city were invited to take part in a prospective study and sub-samples of this cohort were followed-up since then. At the 22-year follow-up, the liver enzymes evaluated were aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma-glutamyl transferase (GGT). Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were obtained calculating the mean of two measurements (at the beginning and the end of the interview) using a blood pressure monitoring device. The co-variables taken into consideration were sex, fasting period, body mass index (BMI), waist circumference (WC), triglycerides, cholesterol, excessive alcohol consumption (>8 points in the Alcohol Use Disorders Identification Test), and physical inactivity. Adjusted linear regressions have been performed and p < 0.05 was considered statistically significant. Results The sample was composed of 2603 (49.6%) men and 2645 (50.4%) women of approximately 22 years old. Median (IQR) AST (U/L) was 21 (18-26), and GGT (U/L) 24 (18-33). Mean (±SD) ALT (U/L) was 19 ± 16.5, SBP (mmHg) 123.9 ± 13.8, and DBP (mmHg) 73 ± 8.7. An increase of 1 U/L in ALT concentrations corresponded to a predicted increase of 0.87 mmHg in SBP and 0.62 mmHg in DBP (Table). This was stronger for GGT, as an increase of 1 U/L in GGT concentrations corresponded to a predicted increase of 1.41 mmHg in SBP and 1.14 mmHg in DBP (Table). AST was not associated with SBP (p = 0.094) or DBP (p = 0.093) (Table). Conclusions ALT and GGT are positively associated with SBP and DBP independent of potential confounders since early adult age. As causal roles remain unclear, prospective large-scale studies are necessary to better understand this association. Abstract Figure.