正常范围内血清谷氨酰基转肽酶与前期高血压的相关性

Correlation of serum glutamyl transpeptidase in the normal range with prehypertension

[目的]观察正常范围内血清谷氨酰基转肽酶(GGT)水平与前期高血压的相关性.[方法]选择自2019年6月至2019年9月间参加健康体格检查的4006例20~60岁非高血压且肝功能正常受检者作为研究对象,分析不同性别人群正常范围内GGT水平与前期高血压的相关性.[结果]与对照组比较,男性前期高血压组年龄、体质量指数(BMI)、血糖(FPG)、总胆固醇(TC)、低密度脂蛋白(LDL)、三酰甘油(TG)、谷草转氨酶(AST)、谷丙转氨酶(ALT)及GGT水平均明显升高(P<0.05);女性前期高血压组年龄、BMI、FPG、TC、LDL、TG、AST、ALT、GGT、尿酸(UA)及肌酐(CREA)水平均明显升高(P<0.05),而高密度脂蛋白(HDL)水平显著降低(P<0.05).男性年龄、BMI、收缩压(SBP)、舒张压(DBP)、FPG、TC、LDL、TG、AST、ALT及UA水平随着GGT水平的升高而升高,而HDL水平随着GGT水平的升高而降低;女性年龄、BMI、SBP、DBP、FPG、TC、LDL、TG、AST、ALT、UA、尿素氮及CREA水平均随着GGT水平的升高而升高.男性未调整时GGT上四分位数组前期高血压的患病风险是下四分位数组的1.881倍(95%CI:1.391~2.544),调整年龄、BMI、FPG、血脂、肝功能等指标后是下四分位数组的1.467倍(95%CI:1.055~2.041);女性未调整时GGT上四分位数组前期高血压的患病风险是下四分位数组的2.295倍(95%CI:1.791~2.939),调整年龄、BMI、FPG、血脂、肝功能及肾功能等指标后上述关系消失.调整年龄、FPG、血脂、肝功能等因素后BMI≥24 kg/m^(2)且GGT水平上四分位数组男性和女性前期高血压患病率分别是BMI<24 kg/m^(2)且GGT水平下四分位数组男性和女性的2.486倍(95%CI:1.634~3.783)和2.027倍(95%CI:1.387~2.962),且男性和女性的前期高血压患病中BMI与GGT水平均有交互作用(P_(交互均)<0.001).[结论]正常范围内GGT水平升高是前期高血压的危险因素,在男性中表现更为突出,且GGT与BMI在前期高血压患病中存在交互作用.

OBJECTIVE To observe the correlation of serum glutamyl transpeptidase(GGT)level in the normal range with prehypertension.METHODS A total of 4006 subjects aged 20-60 years without hypertension and with normal liver function who participated in health physical examination from June 2019 to September 2019 were selected as the study subjects.The correlation of GGT levels within the normal range with prehypertension was analyzed between different genders population.RESULTS Compared with the control group,the age,body mass index(BMI),blood glucose(FPG),total cholesterol(TC),low density lipoprotein(LDL),triglyceride(TG),aspartate aminotransferase(AST),alanine aminotransferase(ALT)and GGT levels were significantly increased in the male prehypertension group(P<0.05).The age,BMI,FPG,TC,LDL,TG,AST,ALT,GGT,uric acid(UA)and creatinine(CREA)in the female prehypertension group were significantly higher(P<0.05),while the level of high density lipoprotein(HDL)was significantly lower(P<0.05).Male age,BMI,systolic blood pressure(SBP),diastolic blood pressure(DBP),FPG,TC,LDL,TG,AST,ALT and UA level increased with the increase of GGT level,while HDL level decreased with the increase of GGT level.Female age,BMI,SBP,DBP,FPG,TC,LDL,TG,AST,ALT,UA,blood urea nitrogen and creatinine(CREA)level increased with the increase of GGT level.In males,unadjusted,the risk of prehypertension in the upper quartile of GGT was 1.881 times higher than the lower quartile(95%CI:1.391-2.544),after adjusting for age,BMI,FPG,blood lipid,liver function and other indicators,it was 1.467 times higher than the lower quartile group(95%CI:1.055-2.041).In females,unadjusted,the risk of prehypertension in the upper quartile of GGT was 2.295 times higher than the lower quartile(95%CI:1.791-2.939),however,this relationship disappeared after adjusting for age,BMI,FPG,lipid profile,liver function,and renal function.After adjusting for age,FBG,lipid profile,liver function and other factors,the prevalence rate of prehypertension in individuals with a BMI≥24 kg/m^(2) and upper quartile of GGT levels was 2.486 times higher(95%CI:1.634-3.783)in males and 2.027 times higher(95%CI:1.387-2.962)in females than those with a BMI<24 kg/m^(2) and lower quartile of GGT levels.Additionally,there was an interaction between BMI and GGT in the prevalence of prehypertension in both males and females(Pinteraction<0.001).CONCLUSION Elevated GGT level within the normal range is a risk factor for prehypertension,particularly in males,and there is an interaction between GGT and BMI in the prevalence of prehypertension.