Association of Serum Uric Acid and Cardiovascular Disease in Healthy Adults
Association of Serum Uric Acid and Cardiovascular Disease in Healthy Adults
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DOI：
10.1016/j.amjcard.2012.12.034
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发表时间：
2013-04-15
影响因子：
2.8
通讯作者：
Olchovsky, David
中科院分区：
文献类型：
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作者：
Kivity, Shaye;Kopel, Eran;Olchovsky, David
对心血管疾病(CVD)高危人群的研究表明，血清尿酸(SUA)与CVD之间存在关联。然而，只有少数研究表明，在健康人群中存在这种关联。这项研究的目的是在一组没有糖尿病或心血管疾病的男性和女性中调查血尿酸和心血管疾病之间的关系。进行了一项回溯性研究，平均随访时间为4.8年。结果是心血管事件的发生，定义为缺血性心脏病、急性冠脉综合征、急性心肌梗死或缺血性中风的诊断。平均尿酸水平男性为6.2+/-1.1 mg/dl(n=6,580)，女性为4.4+/-1.1 mg/dl(n=2,559)。对于女性来说，血尿酸水平最高四分位数的心血管疾病发生率为11.6%，而较低的三个四分位数的心血管疾病发生率为5.0%至6.5%。对于男性来说，血尿酸水平最高四分位数的心血管疾病发生率为14.0%，而最低四分位数的心血管疾病发生率为10.8%。在调整了年龄、血肌酐水平、体重指数、收缩压、低密度脂蛋白胆固醇水平、甘油三酯水平、空腹血糖、体力活动、心血管家族史、利尿剂使用和当前吸烟后，心血管疾病的危险比女性为1.24(95%可信区间1.08~1.41)，男性为1.06(95%可信区间1.00~1.13)(交互作用p=0.04)。总之，与男性相比，女性血尿酸水平与心血管疾病的相关性很强，这突显了在心血管危险因素调查中按性别分层的必要性，并支持探索将血尿酸作为健康人群中心血管疾病风险的标志。(C)2013 Elsevier Inc.保留所有权利。(美国心脏杂志2013；111：1146-1151)
Studies in different populations with high risk for cardiovascular disease (CVD) have shown an association between serum uric acid (SUA) and CVD. However, only a few studies have demonstrated such an association in healthy populations. The aim of this study was to investigate the association between SUA and CVD in a cohort of men and women without diabetes or CVD. A retrospective study was conducted, with a mean 4.8-year follow-up. The outcome was the occurrence of a cardiovascular event, defined as the diagnosis of ischemic heart disease, acute coronary syndrome, acute myocardial infarction, or ischemic stroke. Mean SUA levels were 6.2 +/- 1.1 mg/dl for men (n = 6,580) and 4.4 +/- 1.1 mg/dl for women (n = 2,559). For women, the rate of CVD occurrence was 11.6% for the highest quartile of SUA level, compared with 5.0% to 6.5% for the lower 3 quartiles. For men, the rate of CVD occurrence was 14.0% for the highest quartile of SUA level, compared with 10.8% for the lowest quartile. The hazard ratio for CVD, adjusted for age, serum creatinine level, body mass index, systolic blood pressure, low-density lipoprotein cholesterol level, triglyceride level, plasma fasting glucose, physical activity, cardiovascular family history, use of diuretics, and current smoking, was 1.24 (95% confidence interval 1.08 to 1.41) for women and 1.06 (95% confidence interval 1.00 to 1.13) for men (p for interaction = 0.04). In conclusion, the strong association of SUA levels with CVD in women, compared with the much lesser degree in men, highlights the necessity of stratifying by gender in investigations of cardiovascular risk factors and supports exploration of SUA as a marker of CVD risk in healthy populations. (C) 2013 Elsevier Inc. All rights reserved. (Am J Cardiol 2013;111:1146-1151)