High Serum Uric Acid is Highly Associated with a Reduced Left Ventricular Ejection Fraction Rather than Increased Plasma B-type Natriuretic Peptide in Patients with Cardiovascular Diseases
High Serum Uric Acid is Highly Associated with a Reduced Left Ventricular Ejection Fraction Rather than Increased Plasma B-type Natriuretic Peptide in Patients with Cardiovascular Diseases
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DOI：
10.1038/s41598-018-37053-0
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发表时间：
2019-01-24
影响因子：
4.6
通讯作者：
Yoshimura, Michihiro
中科院分区：
文献类型：
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作者：
Oki, Yoshitsugu;Kawai, Makoto;Yoshimura, Michihiro
据报道，高血清尿酸（UA）与左心室（LV）功能障碍有关；然而，UA与血浆b型利钠肽（BNP）之间的关系尚不清楚。血浆b型利钠肽是心衰的敏感生物标志物。本研究调查了它们之间的关系，以提供高UA的准确评估。该研究的患者包括3,077名因各种心血管疾病而接受心导管插入术的受试者。由于多元回归分析的解释因素多为相互混杂，故采用各自危险因素对研究人群进行四分，并采用协方差结构分析进行亚组分析。该分析显示UA几乎总是与左室射血分数（LVEF）降低密切相关，但通常与BNP无关。在瘦龄女性中，UA与BNP显著相关，而在肥胖青少年男性中则没有，尽管两组的高UA显著降低了LVEF。从BNP角度看，UA高是心功能障碍的直接危险因素；然而，在肥胖的青少年男性中，高UA引起的BNP增加可能受到限制。另一方面，观察到的左室收缩功能障碍，如LVEF，反映了几乎恒定的高UA。
High serum uric acid (UA) has been reported to be associated with left ventricular (LV) dysfunction; however, the relationship between UA and plasma B-type natriuretic peptide (BNP), a sensitive biomarker of heart failure, is still unclear. This study investigated their relationship to provide an accurate assessment of high UA. The study patients consisted of 3,077 subjects who underwent cardiac catheterization because of various cardiovascular disorders. Since the explanatory factors of multiple regression analysis were mostly confounding with each other, subgroup analysis was performed by quartering the study population using the respective risk factors and by covariance structure analysis. This analysis revealed that UA was almost always well associated with a reduced LV ejection fraction (LVEF), but generally not with BNP. UA was significantly associated with BNP in lean aged females, but not in obese adolescent males, although LVEF was significantly reduced in response to a high UA in both groups. A high UA is a direct risk factor for cardiac dysfunction from the perspective of BNP; however, augmentation of BNP in response to a high UA would likely be restricted among obese adolescent males. On the other hand, the observed LV systolic dysfunction, such as LVEF, reflects a high UA on an almost constant basis.