AST/ALT Ratio and Peripheral Artery Disease in a Chinese Hypertensive Population

A Cross-Sectional Study

Liu, Hui MD
Zha, Xiaoyuan MD
Ding, Congcong MD
Hu, Lihua MD
Li, Minghui MD
Yu, Yu MD
Zhou, Wei MD
Wang, Tao MD
Zhu, Lingjuan MD
Bao, Huihui MD, PhD
Cheng, Xiaoshu MD, PhD

¹Department of Cardiovascular Medicine, 196534The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China
²Rancheng Community Health Service Center, Wuyuan, Jiangxi, People’s Republic of China
³Center for Prevention and Treatment of Cardiovascular Diseases, 196534The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, People’s Republic of China

Huihui Bao, Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, Jiangxi 330006, People’s Republic of China. Email: [email protected]

Xiaoshu Cheng, Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, Jiangxi 330006, People’s Republic of China. Email: [email protected]

Angiology 72(10):p 916-922, November 2021. | DOI: 10.1177/00033197211004410

Previous studies reported that the aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AST/ALT) was a risk factor in cardiovascular disease. Peripheral artery disease (PAD) is an important risk factor for cardiovascular death. However, only a few studies investigated the correlations between the AST/ALT ratio and PAD. We analyzed data from 10 900 patients with hypertension from the Chinese Hypertension Registry Study; 350 patients had PAD (prevalence 3.2%). After adjusting for potential confounders, the AST/ALT ratio was independently and positively associated with risk of PAD (OR: 1.31, 95% CI, 1.13-1.59), and a significant increased risk of PAD for the third AST/ALT ratio tertile (T3) compared with the first tertile (T1; OR: 1.49, 95% CI, 1.09-2.04, P_trend = .005) was found. Moreover, when we combined T1 and T2 into one group and used it as a reference group, the risk of PAD increased with the increase in AST/ALT; the risk ratio was 1.52 (95% CI, 1.20-1.95). A higher AST/ALT ratio (≥1.65) was associated with PAD risk in Chinese adults with hypertension. Our results suggest that the AST/ALT ratio may help identify patients at high risk of vascular end points and might be a convenient, economical, and effective tool for evaluating the risk of atherosclerosis.