Uric acid: A new look at an old risk marker for cardiovascular disease, metabolic syndrome, and type 2 diabetes mellitus: The urate redox shuttle.
Uric acid: A new look at an old risk marker for cardiovascular disease, metabolic syndrome, and type 2 diabetes mellitus: The urate redox shuttle.
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DOI：
10.1186/1743-7075-1-10
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发表时间：
2004-10-19
影响因子：
4.5
通讯作者：
Tyagi SC
中科院分区：
文献类型：
--
作者：
Hayden MR;Tyagi SC
尿酸的局部作用及其与心血管疾病、肾脏疾病和高血压的关系正在迅速演变。它在代谢综合征(MS)、2型糖尿病(T2 DM)、动脉粥样硬化、非糖尿病动脉粥样硬化的临床聚集现象中具有重要的历史和现实意义。尿酸是风险的标志，对于其作为风险因素(致病作用)的重要性仍存在争议。在这篇综述中，我们将试图证明它作为加速动脉粥样硬化发展的众多危险因素之一的重要作用，并讨论它作为对内皮、动脉血管壁和毛细血管的多种损伤刺激之一的重要性。尿酸、氧化-氧化还原应激、活性氧物种、内皮一氧化氮减少和内皮功能障碍的作用怎么强调都不为过。在动脉粥样硬化的氧化前期环境中，尿酸的原始抗氧化特性矛盾地变成了氧化剂，从而促进了动脉粥样硬化斑块内脂蛋白的氧化，无论它们起源于MS、T2 DM、加速的动脉粥样硬化(动脉粥样硬化病变)还是非糖尿病的易损性动脉粥样硬化斑块。在这种环境中，存在着抗氧化剂-氧化剂尿酸酸氧化还原穿梭。尿酸升高4 mg/dl应被视为心血管疾病风险患者的“危险信号”，并应提醒临床医生在团队努力中努力利用全球风险降低计划，以减少导致心血管疾病致死后果的动脉粥样硬化过程中的并发症。
The topical role of uric acid and its relation to cardiovascular disease, renal disease, and hypertension is rapidly evolving. Its important role both historically and currently in the clinical clustering phenomenon of the metabolic syndrome (MS), type 2 diabetes mellitus (T2DM), atheroscleropathy, and non-diabetic atherosclerosis is of great importance. Uric acid is a marker of risk and it remains controversial as to its importance as a risk factor (causative role). In this review we will attempt to justify its important role as one of the many risk factors in the development of accelerated atherosclerosis and discuss its importance of being one of the multiple injurious stimuli to the endothelium, the arterial vessel wall, and capillaries. The role of uric acid, oxidative – redox stress, reactive oxygen species, and decreased endothelial nitric oxide and endothelial dysfunction cannot be over emphasized. In the atherosclerotic prooxidative environmental milieu the original antioxidant properties of uric acid paradoxically becomes prooxidant, thus contributing to the oxidation of lipoproteins within atherosclerotic plaques, regardless of their origins in the MS, T2DM, accelerated atherosclerosis (atheroscleropathy), or non-diabetic vulnerable atherosclerotic plaques. In this milieu there exists an antioxidant – prooxidant urate redox shuttle. Elevations of uric acid > 4 mg/dl should be considered a "red flag" in those patients at risk for cardiovascular disease and should alert the clinician to strive to utilize a global risk reduction program in a team effort to reduce the complications of the atherogenic process resulting in the morbid – mortal outcomes of cardiovascular disease.