Uric Acid Levels and Atrial Fibrillation in Hypertensive Patients
Uric Acid Levels and Atrial Fibrillation in Hypertensive Patients
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DOI：
10.2169/internalmedicine.50.4587
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发表时间：
2011-01-01
影响因子：
1.2
通讯作者：
Li, Guangping
中科院分区：
文献类型：
--
作者：
Liu, Tong;Zhang, Xiaowei;Li, Guangping
目的 尿酸（UA）是与氧化应激和炎症相关的心血管风险标志物。最近，心房颤动（AF）与炎症和氧化应激有关。本观察性研究的目的是探讨高血压患者UA水平与AF之间的关联。方法连续筛查高血压患者。我们排除了患有冠状动脉疾病、充血性心力衰竭、糖尿病、瓣膜性心脏病、先天性心脏病、心肌病、肾功能衰竭、炎症、甲状腺功能障碍、呼吸系统疾病以及正在服用影响尿酸代谢的药物（利尿剂除外）的受试者。最终研究人群包括 451 名患者。其中 50 例 (11%) 患有 AF（阵发性：38 例；持续性：8 例；永久性：4 例）。仔细记录人口学、临床、实验室和超声心动图特征。 结果 经过单变量分析，与非 AF 患者相比，AF 患者的年龄、高血压病程、血清肌酐、血清 UA、左心房内径（LAD）、室间隔厚度和左心室后壁厚度显着增加，而 AF 患者的估计肾小球滤过（eGFR）水平远低于非 AF 患者。经过多变量 Logistic 回归分析，AF 的独立预测因子是 UA（OR：1.008；95% CI：1.003-1.013，p=0.002）和 LAD（OR：1.160；95% CI：1.068-1.260；p < 0.001）。 结论 我们证明了高血压患者血清 UA 水平升高与 AF 之间存在独立相关性。患者。毫无疑问，对不同人群进行更大规模的研究应该进一步检验这种潜在的关联以及潜在的病理生理机制。
Objective Uric acid (UA) is a cardiovascular risk marker associated with oxidative stress and inflammation. Recently, atrial fibrillation (AF) has been associated with inflammation and oxidative stress. The objective of this observational study was to investigate the association between UA levels and AF in hypertensive patients.Methods Consecutive patients with hypertension were screened. We excluded subjects with coronary artery disease, congestive heart failure, diabetes, valvular heart disease, congenital heart disease, cardiomyopathy, renal failure, inflammatory conditions, thyroid dysfunction, respiratory diseases, and those who were taking drugs that affect UA metabolism (apart from diuretics). The final study population consisted of 451 patients. Fifty of them (11%) had AF (paroxysmal: 38; persistent: 8; permanent: 4). Demographic, clinical, laboratory, and echocardiographic characteristics were carefully recorded.Results After univariate analysis, age, duration of hypertension, serum creatinine, serum UA, left atrial diameter (LAD), interventricular septum thickness, and left ventricular posterior wall thickness were significantly increased in patients with AF compared with non-AF patients, while the estimated glomerular filtration (eGFR) level was much lower in patients with AF than in those without AF. After multivariate logistic regression analysis, the independent predictors of AF were UA (OR: 1.008; 95% CI: 1.003-1.013, p=0.002) and LAD (OR: 1.160; 95% CI: 1.068-1.260; p < 0.001).Conclusion We demonstrated an independent association between increased serum UA levels and AF in hypertensive patients. Undoubtedly, larger studies in different populations should further examine this potential association as well as the underlying pathophysiological mechanisms.