Relationships Among Hyperuricemia, Metabolic Syndrome, and Endothelial Function
Relationships Among Hyperuricemia, Metabolic Syndrome, and Endothelial Function
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DOI：
10.1038/ajh.2011.55
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发表时间：
2011-07-01
影响因子：
3.2
通讯作者：
Yamashina, Akira
中科院分区：
文献类型：
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作者：
Tomiyama, Hirofumi;Higashi, Yukihito;Yamashina, Akira
背景：我们评估了患有代谢综合征(METS)和不患有代谢综合征(METS)的患者高尿酸血症的严重程度与血流介导的肱动脉血管扩张(FMD)的关系。方法在一项横断面研究中，2732名日本健康男性(49.8岁)获得了FMD，他们没有心血管疾病，也没有接受任何治疗心血管疾病危险因素的药物。根据日本标准定义METS，血清尿酸(UA)水平在第5(最高)五分之一范围的上半部分被定义为重度高尿酸血症，而在该五分之一范围的下半部分被定义为轻度高尿酸血症。结果总体上，有METS的受试者的FMD调整值(5.6+/-0.1%；n=413)低于无METS的受试者(6.2+/-0.1%；n=2,319)(P<；0.01)。在无甲硫氨酸的受试者中，轻度高尿酸血症亚组和重度高尿酸血症亚组的FMD调整值均低于非高尿酸血症亚组。相反，在患有METS的受试者中，只有重度高尿酸血症患者的FMD调整值(4.8+/-0.3%)低于非高尿酸血症患者(5.7+/-0.2%)(P<；0.05)。结论在未患METS的日本中年男性中，不仅严重的高尿酸血症而且轻度的高尿酸血症可能是内皮功能障碍的显著独立危险因素，而在类似的METS患者中，只有严重的高尿酸血症(而不是轻度的高尿酸血症)才可能加重内皮功能障碍。
BACKGROUNDWe evaluated the relationship of the severity of hyperuricemia and the flow-mediated vasodilatation of the brachial artery (FMD) in patients with and without the metabolic syndrome (MetS).METHODSIn a cross-sectional study, FMD was obtained in 2,732 Japanese healthy men (49 8 years) who had no cardiovascular (CV) disease and were not on any medication for CV risk factors. MetS was defined according to Japanese criteria, and serum uric acid (UA) levels in the upper half of the fifth (highest) quintile range were defined as severe hyperuricemia, whereas those in the lower half of this quintile range were defined as mild hyperuricemia.RESULTSOverall, the adjusted values of FMD were lower in the subjects with MetS (5.6 +/- 0.1%; n = 413) than in those without MetS (6.2 +/- 0.1%; n = 2,319) (P < 0.01). Among the subjects without MetS, the adjusted values of FMD were lower in both the subgroups with mild hyperuricemia and severe hyperuricemia than in the subgroup without hyperuricemia. On the contrary, among the subjects with MetS, the adjusted value of FMD was lower only in the subgroup with severe hyperuricemia (4.8 +/- 0.3%) as compared with that in the group without hyperuricemia (5.7 +/- 0.2%) (P < 0.05).CONCLUSIONSIn middle-aged healthy Japanese men without MetS, not only severe, but also mild hyperuricemia may be a significant independent risk factor for endothelial dysfunction in subjects without MetS, whereas only severe hyperuricemia (but not mild hyperuricemia) appeared to exacerbate endothelial dysfunction in similar subjects with MetS.