Uric acid in the pathogenesis of metabolic, renal, and cardiovascular diseases: A review.

Uric acid in the pathogenesis of metabolic, renal, and cardiovascular diseases: A review.
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DOI:
10.1016/j.jare.2016.11.004
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发表时间:
2017-09
影响因子:
10.7
通讯作者:
Abdulazim DO
Abdulazim DO
中科院分区:
综合性期刊2区
文献类型:
--
作者:
Sharaf El Din UAA;Salem MM;Abdulazim DO

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尿酸(UA)与系统性高血压(Htn)、血脂异常、葡萄糖耐受不良、超重、脂肪肝、肾脏疾病和心血管疾病(CVD)之间的关系已得到广泛认可。然而,UA和这些不同的临床问题之间的因果关系仍然是有争议的。近年来,已有数百项实验和临床试验支持UA是这些疾病实体发病机制中可能的参与者的观点。这些研究揭示了高尿酸血症与代谢综合征(MS)、肥胖、HTN、2型糖尿病(DM)、非酒精性脂肪肝、高尿酸血症、急性肾损伤、慢性肾脏病(CKD)、冠心病(CHD)、心力衰竭以及心脏病和CKD患者死亡率增加之间的密切关系。UA与肾结石或先兆子痫之间的关联是无可争议的关联。最近的实验研究揭示了UA诱导的酶活性的不同变化。一氧化氮(NO)合酶、腺苷一磷酸激酶(AMPK)、腺苷一磷酸脱氢酶(AMPD)和烟酰胺腺嘌呤二核苷酸磷酸(NADPH)氧化酶受UA影响。酶活性的这些变化可导致观察到的与UA相关的生化和病理变化。最近的实验、临床、干预和流行病学试验支持UA在MS、肾脏和心血管疾病发病机制中的致病作用的概念。
The association between uric acid (UA) on one side and systemic hypertension (Htn), dyslipidemia, glucose intolerance, overweight, fatty liver, renal disease and cardiovascular disease (CVD) on the other side is well recognized. However, the causal relationship between UA and these different clinical problems is still debatable. The recent years have witnessed hundreds of experimental and clinical trials that favored the opinion that UA is a probable player in the pathogenesis of these disease entities. These studies disclosed the strong association between hyperuricemia and metabolic syndrome (MS), obesity, Htn, type 2 diabetes mellitus (DM), non-alcoholic fatty liver disease, hypertriglyceridemia, acute kidney injury, chronic kidney disease (CKD), coronary heart disease (CHD), heart failure and increased mortality among cardiac and CKD patients. The association between UA and nephrolithiasis or preeclampsia is a non-debatable association. Recent experimental trials have disclosed different changes in enzyme activities induced by UA. Nitric oxide (NO) synthase, adenosine monophosphate kinase (AMPK), adenosine monophosphate dehydrogenase (AMPD), and nicotinamide adenine dinucleotide phosphate (NADPH)-oxidase are affected by UA. These changes in enzymatic activities can lead to the observed biochemical and pathological changes associated with UA. The recent experimental, clinical, interventional, and epidemiologic trials favor the concept of a causative role of UA in the pathogenesis of MS, renal, and CVDs.
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