Asymptomatic Hyperuricemia Without Comorbidities Predicts Cardiometabolic Diseases: Five-Year Japanese Cohort Study.
Asymptomatic Hyperuricemia Without Comorbidities Predicts Cardiometabolic Diseases: Five-Year Japanese Cohort Study.
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DOI：
10.1161/hypertensionaha.116.08998
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发表时间：
2017-06
期刊：
影响因子：
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通讯作者：
Johnson RJ
中科院分区：
文献类型：
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作者：
Kuwabara M;Niwa K;Hisatome I;Nakagawa T;Roncal-Jimenez CA;Andres-Hernando A;Bjornstad P;Jensen T;Sato Y;Milagres T;Garcia G;Ohno M;Lanaspa MA;Johnson RJ
无合并症的无症状高尿酸血症是否会增加心脏代谢紊乱和慢性肾脏疾病的风险仍存在争议。本研究旨在阐明无症状高尿酸血症与心脏代谢状况之间的关系。研究对象由30至85岁的日本成年人组成，在东京圣路加国际医院预防医学中心登记，并在登记（2004年）和5年随访（2009年）时提供。如果受试者超重或肥胖、高血压、糖尿病、血脂异常、有痛风或药物治疗的高尿酸血症史，或患有肾小球滤过率<60 ml/min/1.73m2的慢性肾脏疾病，则排除受试者。采用线性和逻辑回归分析来检验高尿酸血症与高血压、糖尿病、血脂异常、慢性肾病和超重/肥胖（未调整和调整年龄、性别、吸烟、饮酒习惯、基线估计肾小球滤过率和体重指数）发展之间的关系。5899名无合并症的受试者（平均年龄47±10岁，男性1864名）随访5年。高尿酸血症（定义为男性≥7 mg/dL，女性≥6 mg/dL）与高血压（14.9% vs 6.1%, p<0.001）、血脂异常（23.1% vs 15.5%, p<0.001）、慢性肾脏疾病（19.0% vs 10.7%, p<0.001）和超重/肥胖（8.9% vs 3.0%, p<0.001）的累积发病率增加相关，而糖尿病（1.7% vs 0.9%, p=0.087）有上升趋势，但未达到统计学意义。总之，无症状高尿酸血症在无合并症的日本个体中具有发生心脏代谢疾病的显著风险。
Whether asymptomatic hyperuricemia in the absence of comorbidities increases the risk for cardiometabolic disorders and chronic kidney disease remains controversial. This study was conducted to clarify the association between asymptomatic hyperuricemia and cardiometabolic conditions. Subjects consisted of Japanese adults between 30 and 85 years of age were enrolled in the study at Center for Preventive Medicine, St. Luke's International Hospital, Tokyo, and available at enrollment (2004) and at 5-year follow-up (2009). Subjects were excluded if they were overweight or obese, hypertensive, diabetic, dyslipidemic, had a history of gout or hyperuricemia on medications, or if they had chronic kidney disease as estimated glomerular filtration rate <60 ml/min/1.73m2. Linear and logistic regression analyses were used to examine the relationship between hyperuricemia and development of hypertension, diabetes mellitus, dyslipidemia, chronic kidney disease, and overweight/obesity (unadjusted and adjusted for age, sex, smoking, drinking habits, baseline estimated glomerular filtration rate and body mass index). 5,899 subjects without comorbidities (mean age of 47 ± 10 years, 1,864 men) were followed for 5 years. Hyperuricemia (defined as >7 mg/dL in men and ≥6 mg/dL in women) was associated with increased cumulative incidence rates of hypertension (14.9% vs 6.1%, p<0.001), dyslipidemia (23.1% vs 15.5%, p<0.001), chronic kidney disease (19.0% vs 10.7%, p<0.001), and overweight/obesity (8.9% vs 3.0%, p<0.001), while diabetes mellitus (1.7% vs 0.9%, p=0.087) showed a trend but did not reach statistical significance. In conclusion, asymptomatic hyperuricemia carries a significant risk for developing cardiometabolic conditions in Japanese individual without comorbidities.