Association between raised blood pressure and elevated serum liver enzymes among active-duty Royal Thai Army personnel in Thailand

Abstract: Background: The relationship between hypertension (HT) and serum liver enzymes was reported in a few studies, but the findings were inconsistent. Therefore, the present study aimed to identify the association between elevated serum liver enzymes and raised BP through the use of a large sample of Royal Thai Army (RTA) personnel. Methods: The dataset obtained from the annual health examination database of RTA personnel in Thailand was utilized. A total of 244,281 RTA personnel aged 35–60 were included in the current study. Elevated serum liver enzymes were defined as aspartate aminotransferase (AST) or alanine aminotransferase (ALT) ≥ 40 U/L in males and ≥ 35 U/L in females. HT was defined as systolic BP ≥ 140 or diastolic BP ≥ 90 mmHg. A multivariable linear regression model was used to estimate the coefficient and 95% confidence intervals (CI), whereas a multivariable logistic regression model was applied to estimate adjusted odds ratios (AORs) and 95% CI for the association between raised BP and serum liver enzymes. Results: Compared to individuals with SBP < 120 and DBP < 80 mmHg, the β coefficients of log-transformed AST and ALT were 0.13 (95% CI: 0.12–0.13) and 0.11 (95% CI: 0.11–0.12) in males with HT. Meanwhile, the β coefficients of log-transformed AST and ALT were 0.03 (95% CI: 0.02–0.04) and 0.07 (95% CI: 0.05–0.08) in females with HT. In males, HT was associated with elevated AST (AOR: 1.92; 95% CI: 1.85–2.01) and elevated ALT (AOR: 1.43; 95% CI: 1.38–1.48). On the other hand, in females, HT was associated with elevated AST (AOR: 1.42; 95% CI: 1.21–1.66) and elevated ALT (AOR: 1.38; 95% CI: 1.21–1.57). Conclusion: Raised BP was positively correlated with elevated AST and ALT in active-duty RTA personnel. Moreover, HT was independently attributed to higher odds of elevated AST and ALT in comparison to optimal BP in both males and females. Furthermore, the relationship between serum liver enzymes and BP was modified by sex.

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