Uric acid is not an independent predictor of cardiovascular mortality in type 2 diabetes: A population-based study
Uric acid is not an independent predictor of cardiovascular mortality in type 2 diabetes: A population-based study
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DOI：
10.1016/j.atherosclerosis.2011.11.042
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发表时间：
2012-03-01
期刊：
影响因子：
5.3
通讯作者：
Bruno, Graziella
中科院分区：
文献类型：
--
作者：
Panero, F.;Gruden, G.;Bruno, Graziella
目的：虽然一些研究表明，尿酸是一个危险因素的死亡率，这种关系仍然是不确定的人与2型diabetes.Methods：本研究的基础是人口为基础的队列1540糖尿病受试者（中位年龄68.9岁）的Casale Monferrato研究。血尿酸对15年全因，心血管和非心血管死亡率的作用进行了评估，多变量考克斯比例风险modeling.Results：基线水平的血尿酸与HbA 1c呈负相关，男性和老年人较高，独立与代谢综合征的组成部分。在14,179人-年中，观察到1000例死亡（514例死于心血管疾病）。与尿酸的下四分位数相比，上四分位数中全因死亡率的HR（95% CI）为1.47（1.22-1.76）;心血管死亡率为1.40（1.09-1.80），非心血管死亡率为1.50（1.15-1.96）。然而，在多个调整模型中，HR为1.30（1.06-1.60）全因死亡率为1.13（0.85-1.50）心血管死亡率和1.50（1.11-2.02）非心血管死亡率（男性1.87，1.19-2.95;女性1.20，0.80-1.80）;后者似乎是由于肿瘤性疾病（所有组合四分位数与下四分位数的HR：两种性别均为1.59，1.05-2.40;男性为1.54，0.83-2.84，女性为1.68，0.95-2.92）。在糖尿病患者中，尿酸与代谢综合征的成分有关，但它可能不是心血管死亡的独立危险因素。尿酸水平升高的全因死亡风险增加可能是由于肿瘤死亡率增加，值得进一步研究。(C)由Elsevier爱尔兰有限公司出版。
Objective: Although some studies have suggested that uric acid is a risk factor for mortality, this relationship is still uncertain in people with type 2 diabetes.Methods: The study base was the population-based cohort of 1540 diabetic subjects (median age 68.9 years) of the Casale Monferrato Study. The role of serum uric acid on 15-years all-cause, cardiovascular and non-cardiovascular mortality was assessed by multivariate Cox proportional hazards modeling.Results: Baseline levels of serum uric acid were negatively correlated with HbA1c, were higher in men and in the elderly and were independently associated with components of the metabolic syndrome. Out of 14,179 person-years, 1000 deaths (514 due to cardiovascular diseases) were observed. Compared to the lower quartile of uric acid, HRs (95% CI) in the upper quartile were 1.47 (1.22-1.76) for all-cause mortality; 1.40 (1.09-1.80) for cardiovascular mortality and 1.50 (1.15-1.96) for non-cardiovascular mortality. In multiple adjusted models, however, HRs were 1.30 (1.06-1.60) for all-cause mortality, 1.13 (0.85-1.50) for cardiovascular mortality and 1.50 (1.11-2.02) for non-cardiovascular mortality (men 1.87, 1.19-2.95; women 1.20, 0.80-1.80); the latter appeared to be due to neoplastic diseases (HR in all combined quartiles vs. lower quartile: both sexes 1.59, 1.05-2.40; men 1.54, 0.83-2.84, women 1.68, 0.95-2.92).Conclusions: In diabetic people, uric acid is associated with components of the metabolic syndrome but it may not be accounted as an independent risk factor for cardiovascular mortality. The increased all-cause mortality risk with higher levels of uric acid might be due to increased neoplastic mortality and deserves future studies. (C) 2012 Published by Elsevier Ireland Ltd.