Association Between AST to ALT Ratio and Peripheral Artery Disease in Chinese Hypertensive Population: A Cross-Sectional Study

Abstract Background: Previous studies had shown the role of aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio (AST/ALT) in cardiovascular disease . Peripheral artery disease(PAD) is an important risk factor for cardiovascular death. However, there are fewer investigations of the correlations between the AST/ALT ratio and Peripheral artery disease (PAD). Methods: We analyzed data of 10,900 hypertensive patients from the Chinese Hypertension Registry Study. Using a multivariate logistic regression model, we examined the association between AST / ALT and peripheral arterial disease (PAD),which was defined as ABI≤ 0.9 in either leg.Results：A total of 350 patients had peripheral arterial disease and the prevalence of PAD was 3.21%. After adjusting for potential confounders, AST / ALT ratio was independently and positively associated with risk of PAD (OR: 1.31, 95% CI: 1.13 to 1.59), and a statistically significant increased risk of PAD for the third AST / ALT ratio tertile (T3) compared to the first tertile (T1) (OR:1.49, 95% CI: 1.09 to 2.04, P-trend= 0.005) was found. Moreover, when we combined T1-T2 into one group and used it as a reference group, the risk of PAD increased with the increase of AST/ALT and the risk ratio was 1.52 (95% CI :1.20 to 1.95). Conclusion: A higher AST/ALT ratio (≥1.65) was associated with PAD risk in Chinese adults with hypertension. Our results suggested that AST / ALT maybe help us highlight patients who was at high risk of vascular endpoints.Trial registration: CHICTR, CHiCTR1800017274. Registered 20 July 2018.