Liver indicators affecting the relationship between BMI and hypertension in type 2 diabetes: a mediation analysis.
Xuelin Yao, Keyan Hu, Zhen Wang, Fangting Lu, Jie Zhang, Yahu Miao, Qing Feng, Tian Jiang, Yi Zhang, Songtao Tang, Nan Zhang, Fang Dai, Honglin Hu, Qiu Zhang, China National Diabetic Chronic Complications Study Group
Author Information
Xuelin Yao: Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, 230032, Hefei, China.
Keyan Hu: Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, 230032, Hefei, China.
Zhen Wang: Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, 230032, Hefei, China.
Fangting Lu: Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, 230032, Hefei, China.
Jie Zhang: Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, 230032, Hefei, China.
Yahu Miao: Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, 230032, Hefei, China.
Qing Feng: Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, 230032, Hefei, China.
Tian Jiang: Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, 230032, Hefei, China.
Yi Zhang: Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, 230032, Hefei, China.
Songtao Tang: Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, 230032, Hefei, China.
Nan Zhang: Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, 230032, Hefei, China.
Fang Dai: Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, 230032, Hefei, China.
Honglin Hu: Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, 230032, Hefei, China. huhonglin@ahmu.edu.cn.
Qiu Zhang: Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, 218 Jixi Road, Shushan District, 230032, Hefei, China. zhangqiu@ahmu.edu.cn.
BACKGROUND: Body mass index (BMI) is an important risk factor for hypertension in diabetic patients. However, the underlying mechanisms remain poorly understood. Although liver-derived biological intermediates may play irreplaceable roles in the pathophysiology of diabetes, few studies have explored them in the association between BMI and hypertension in diabetes. OBJECTIVE: To investigate the role of liver enzymes in mediating the relationship between BIM exposure and hypertension in type 2 diabetes mellitus (T2DM). METHODS: We included a total of 1765 participants from the China National Diabetic Chronic Complications Study Cohort. Associations between liver enzymes and hypertension were estimated using multivariable regression models. The function of liver indicators in the relationship between BMI and hypertension was assessed using mediation analysis. Mediation analysis was conducted, taking into account age, diabetes duration, current smoking, fasting plasma glucose level, glycated hemoglobin, anti-diabetic therapy, and family history of diseases, including diabetes, hypertension, obesity, and hyperlipidemia. RESULTS: For men, the association of BMI with hypertension was partially mediated by alanine aminotransferase (ALT), with a proportion of mediation was 68.67%, by aspartate aminotransferase (AST) was 27.02%, and by γ-glutamyltransferase (GGT) was 38.58%, by AST/ALT was 63.35%; for women, the proportion mediated by ALT was 36.93%, and by AST was 37.47%, and GGT was 44.60%, and AST/ALT was 43.73% for BMI (all P < 0.05). CONCLUSION: The effect of BMI on hypertension is partly mediated by liver indicators (ALT, AST, GGT, and AST/ALT) in diabetic patients. Our results may provide opportunities to identify new targets for hypertension interventions.
