U-shaped relationship between serum uric acid levels and intrarenal hemodynamic parameters in healthy subjects
U-shaped relationship between serum uric acid levels and intrarenal hemodynamic parameters in healthy subjects
复制标题
健康受试者血清尿酸水平与肾内血流动力学参数之间的U型关系
DOI：
10.1152/ajprenal.00645.2016
复制
发表时间：
2017-06-01
影响因子：
4.2
通讯作者：
Inaba, Masaaki
中科院分区：
文献类型：
--
作者：
Uedono, Hideki;Tsuda, Akihiro;Inaba, Masaaki
据报道，高尿酸血症会影响肾脏血流动力学。在最近的一项研究中，发现低水平和高水平的血清尿酸（SUA）与肾功能丧失有关。本研究的目的是使用对氨基马尿酸（C-PAH）和菊粉（C-in）的血浆清除率评价健康受试者SUA水平与肾内血流动力学参数之间的关系。通过同时测定48名健康受试者（54.6 ± 13.4岁）的CPAH和Cin来评价肾脏和肾小球血流动力学。使用Gomez公式计算肾内血流动力学参数，包括传出和传入（R-a）小动脉阻力。研究SUA水平与这些肾内血流动力学参数的关系。在二次回归分析中，SUA水平与Cin（P < 0.0001，R-2 = 0.350）和CPAH（P = 0.0093，R-2 = 0.188）呈显著的倒U型关系，与R-a（P = 0.0011，R-2 = 0.262）呈显著的U型关系。在多元回归分析中，（3.5-6.0 mg/dl）和轻度偏低或偏高（6.0 mg/dl）SUA水平分别作为虚拟变量0和1输入，轻度低或高SUA水平与R-a显著独立相关经多因素校正后（R-2 = 0.597，P < 0.0001），β = 0.230，P = 0.0403。轻度高尿酸血症和轻度低尿酸血症均与R-a增加显著相关，尽管相关性较弱。轻度高尿酸血症或低尿酸血症受试者的R-a升高可能与肾血流动力学异常有关，可能导致肾功能下降。
Hyperuricemia has been reported to affect renal hemodynamics. In a recent study, both low and high levels of serum uric acid (SUA) were found to be associated with loss of kidney function. The goal of this study was to evaluate the relationship between SUA levels and intrarenal hemodynamic parameters in healthy subjects, using plasma clearance of para-aminohippurate (C-PAH) and inulin (C-in). Renal and glomerular hemodynamics were evaluated by simultaneous measurements of CPAH and Cin in 48 healthy subjects (54.6 +/- 13.4 yr). Intrarenal hemodynamic parameters, including efferent and afferent (R-a) arteriolar resistance, were calculated using Gomez's formulas. Relationships of SUA levels with these intrarenal hemodynamic parameters were examined. In quadratic regression analysis, SUA levels had a significant inverse U-shaped relationship with Cin (P < 0.0001, R-2 = 0.350) and CPAH (P = 0.0093, R-2 = 0.188) and a U-shaped relationship with R-a (P = 0.0011, R-2 = 0.262). In multiple regression analysis with normal (3.5-6.0 mg/dl) and mildly low or high (6.0 mg/dl) SUA levels entered as dummy variables of zero and one, respectively, mildly low or high SUA levels were significantly and independently associated with R-a (beta = 0.230, P = 0.0403) after adjustment for several factors (R-2 = 0.597, P < 0.0001). Both mild hyperuricemia and mild hypouricemia are significantly associated with increased R-a, although weakly. The increase in R-a in subjects with mild hyperuricemia or hypouricemia may be related to renal hemodynamic abnormalities, possibly leading to a decline in renal function.