Serum uric acid and risk of ischemic stroke: The ARIC Study
Serum uric acid and risk of ischemic stroke: The ARIC Study
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DOI：
10.1016/j.atherosclerosis.2005.09.020
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发表时间：
2006-08-01
期刊：
影响因子：
5.3
通讯作者：
Shahar, Eyal
中科院分区：
文献类型：
--
作者：
Hozawa, Atsushi;Folsom, Aaron R.;Shahar, Eyal
目的：由于血清尿酸（UA）与心血管危险因素密切相关，因此一直存在争议，血清UA是否是卒中危险因素，或者UA是否只是将受试者与其他因果危险因素“标记”在一起。因此，我们在社区动脉粥样硬化风险（ARIC）Study.Methods和结果中调查了UA和缺血性卒中之间的关系：在15，792名ARIC参与者中，13，413名基线时无公认的卒中或冠心病（CHD），并有基线UA测量值的人被纳入分析。我们随访了参与者12.6年的缺血性卒中发病率（N=381）。虽然当我们校正年龄、性别、种族和教育时，血清UA与缺血性卒中发病率独立正相关，但当额外校正可能的混杂变量时，正相关性减弱。在未使用利尿剂的受试者中观察到血清UA与缺血性卒中之间的正相关性（最高四分位数与最低四分位数的校正相对风险：相对风险（RH）= 1.49; 95%置信区间（CI）：1.00-2.23）（趋势P值：0.02），但在利尿剂使用者中并非如此（相互作用的P：0.08）。我们的研究结果表明，在未使用利尿剂的受试者中，UA是缺血性卒中的独立预测因子，但尿酸升高本身可能不会引起缺血性中风。(c)2005爱思唯尔爱尔兰有限公司保留所有权利。
Aims: Since serum uric acid (UA) is strongly associated with cardiovascular risk factors, it has been debated whether serum UA is a stroke risk factor or whether UA may be simply "marking" subjects with other, causal risk factors. We therefore investigated the relation between UA and ischemic stroke in the Atherosclerosis Risk in Communities (ARIC) Study.Methods and results: Of 15,792 ARIC participants, 13,413 who were free of recognized stroke or coronary heart disease (CHD) at baseline and had a baseline UA measurement were included in the analysis. We followed the participants for ischemic stroke incidence (N=381) over 12.6 years. Although serum UA was independently and positively related to ischemic stroke incidence when we adjusted for age, sex, race, and education, the positive relation was weakened when additionally adjusted for possible confounding variables. The positive multivariate-adjusted association between serum UA and ischemic stroke was observed among subjects not using diuretics (adjusted relative hazard in the highest quartile versus the lowest: relative hazard (RH) = 1.49; 95% confidence interval (CI): 1.00-2.23) (P for trend: 0.02), but not among diuretic users (P for interaction: 0.08).Conclusion: Our findings suggest that UA is an independent predictor of ischemic stroke among subjects not using diuretics, but that elevated UA itself may not cause ischemic stroke. (c) 2005 Elsevier Ireland Ltd. All rights reserved.