Serum uric acid levels and mortality in the Japanese population: the Yamagata (Takahata) study
Serum uric acid levels and mortality in the Japanese population: the Yamagata (Takahata) study
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DOI：
10.1007/s10157-016-1228-1
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发表时间：
2016-12-01
影响因子：
2.3
通讯作者：
Kubota, Isao
中科院分区：
文献类型：
--
作者：
Kamei, Keita;Konta, Tsuneo;Kubota, Isao
血尿酸水平受性别、饮食习惯、遗传倾向和肾功能的调节，并与肾脏和心血管疾病的发生有关。本研究前瞻性地调查了社区人群中血清尿酸水平与死亡率之间的关系，来自日本Takahata镇的3487名受试者（45%为男性;平均年龄62岁）参加了本研究，并随访了8年（中位数7.5年），不考虑抗高尿酸血症药物。我们分别研究了基线血清尿酸水平与全因死亡率和心血管死亡率之间的关系，随访期间有179例受试者死亡，其中49例死亡归因于心血管原因。Kaplan-Meier分析显示，沿着基线时血清尿酸水平的升高，女性受试者的全因死亡率显著升高（Log-rank P < 0.01），但男性受试者的全因死亡率无显著差异（P = 0.97）。Cox比例风险模型分析调整了可能的混杂因素，包括年龄、肾功能和合并症，显示高尿酸血症在女性患者中，（尿酸AE 7.0 mg/dL）分别是全因死亡率和心血管死亡率的独立风险因素[全因死亡率的风险比（HR）5.92，95%置信区间（CI）2.10-14.6，HR 10.7，在社区人群中，高尿酸血症是女性全因死亡率和心血管死亡率的独立危险因素，但在男性受试者中不是。
Serum uric acid level is regulated by gender, dietary habit, genetic predisposition, and renal function, and is associated with the development of renal and cardiovascular diseases. This study prospectively investigated the association between serum uric acid levels and mortality in a community-based population.Three thousand four hundred and eighty-seven subjects regardless of the antihyperuricemic medication (45 % male; mean age 62 years old) from the Takahata town in Japan participated in this study and were followed up for 8 years (median 7.5 years). We examined the association between serum uric acid levels at baseline and the all-cause and cardiovascular mortality, respectively, in this population.One hundred seventy-nine subjects died during the follow-up period, with 49 deaths attributed to cardiovascular causes. Kaplan-Meier analysis revealed that the all-cause mortality was significantly higher along with the increase in serum uric acid levels at baseline among female (Log-rank P < 0.01), but not male subjects (P = 0.97). Cox-proportional hazard model analysis with adjustment for possible confounders including age, renal function, and comorbidities revealed that hyperuricemia (uric acid ae7.0 mg/dL) was an independent risk factor for all-cause and cardiovascular mortality, respectively, in female [hazard ratio (HR) 5.92, 95 % confidence interval (CI) 2.10-14.6 for all-cause mortality, and HR 10.7, 95 % CI 1.76-50.2 for cardiovascular mortality], but not male subjects.Hyperuricemia was an independent risk for all-cause and cardiovascular mortality in female, but not among the male subjects in a community-based population.