Hyperuricaemia and gout in cardiovascular, metabolic and kidney disease
Hyperuricaemia and gout in cardiovascular, metabolic and kidney disease
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DOI：
10.1016/j.ejim.2020.07.006
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发表时间：
2020-10-01
影响因子：
8
通讯作者：
Tsioufis, Konstantinos P.
中科院分区：
文献类型：
--
作者：
Borghi, Claudio;Agabiti-Rosei, Enrico;Tsioufis, Konstantinos P.
在上个世纪，高尿酸血症在许多人群中的患病率不断上升。虽然通常在痛风的背景下讨论尿酸，但高尿酸血症也与高血压、慢性肾脏疾病、高甘油三酯血症、肥胖、动脉粥样硬化性心脏病、代谢综合征和2型糖尿病有关。在这里，我们回顾了高尿酸血症与心血管、肾脏和代谢性疾病的关系。与普遍认为的尿酸是嘌呤代谢的惰性代谢物相反，最近的研究表明，血清尿酸可能具有多种促炎、促氧化和血管收缩作用，可能导致心脏代谢性疾病。高尿酸血症是高血压、代谢综合征、2型糖尿病、冠状动脉疾病、左室肥厚、房颤、心肌梗死、中风、心力衰竭和慢性肾脏疾病发展的预测因素。在一些但不是所有的研究中，降尿酸疗法也被发现可以改善高血压和肾脏疾病患者的预后。总之，尿酸正在成为心脏代谢性疾病潜在的可治疗危险因素，建议对有或没有沉积的高尿酸血症并伴有高血压、代谢综合征或慢性肾脏疾病的患者进行更多临床试验，研究降低血尿酸的潜在益处。
During the last century, there has been an increasing prevalence of hyperuricaemia noted in many populations. While uric acid is usually discussed in the context of gout, hyperuricaemia is also associated with hypertension, chronic kidney disease, hypertriglyceridaemia, obesity, atherosclerotic heart disease, metabolic syndrome, and type 2 diabetes. Here we review the connection between hyperuricaemia and cardiovascular, kidney and metabolic diseases. Contrary to the popular view that uric acid is an inert metabolite of purine metabolism, recent studies suggest serum uric acid may have a variety of pro-inflammatory, pro-oxidative and vasoconstrictive actions that may contribute to cardiometabolic diseases. Hyperuricaemia is a predictive factor for the development of hypertension, metabolic syndrome, type 2 diabetes, coronary artery disease, left ventricular hypertrophy, atrial fibrillation, myocardial infarction, stroke, heart failure and chronic kidney disease. Treatment with uric acid-lowering therapies has also been found to improve outcomes in patients with hypertension and kidney disease, in some but not all studies. In conclusion, uric acid is emerging as a potentially treatable risk factor for cardiometabolic diseases, and more clinical trials investigating the potential benefit of lowering serum uric acid are recommended in individuals with hyperuricaemia with and without deposition and concomitant hypertension, metabolic syndrome or chronic kidney disease.