Serum uric acid is a strong predictor of stroke in patients with non-insulin-dependent diabetes mellitus
Serum uric acid is a strong predictor of stroke in patients with non-insulin-dependent diabetes mellitus
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DOI：
10.1161/01.str.29.3.635
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发表时间：
1998-03-01
期刊：
影响因子：
8.3
通讯作者：
Laakso, M
中科院分区：
文献类型：
--
作者：
Lehto, S;Niskanen, L;Laakso, M
背景和目的：非胰岛素依赖型糖尿病（NTT）患者发生卒中的风险增加。高尿酸血症是NIDDM的常见表现，但其作为心血管疾病独立危险因素的意义尚不明确。因此，我们调查了血清尿酸作为中风的预测因子在NIDDM患者无临床肾病（即，血清肌酐水平小于或等于120 μ mol/L）。方法，在这项以人群为基础的研究，心血管危险因素确定在1017例（551名男性和466名女性）NIDDM患者，年龄在基线45至64岁。结果在随访期间，31例NIDDM患者（12例男性[2.2%]和19例女性[4.1%]）死于卒中，114例NIDDM患者（55例男性[10.0%]和59例女性[12.7%]）有致命或非致命性卒中。通过考克斯回归分析，卒中发病率随血清尿酸水平的四分位数显著增加（P295 μ mol/L）与致死性和非致死性卒中的风险显著相关（风险比，1.93 [1.30 - 2.86]; P= 0.001）。即使调整了所有心血管危险因素后，这种相关性仍然具有统计学意义（风险比，1.91 [1.24至2.94[; P= 0.003]）。结论-我们的研究结果表明，高尿酸血症是中年NIDDM患者卒中事件的一个强有力的预测因子，独立于其他心血管危险因素。
Background and Purpose-Patients with non-insulin-dependent diabetes mellitus (NTT)DM) are at increased risk for stroke. Hyperuricemia is a common finding in NIDDM, but its significance as an independent risk factor for cardiovascular disease has remained uncertain. Therefore, we investigated serum urate as a predictor of stroke in NIDDM patients free of clinical nephropathy (ie, with a serum creatinine level of less than or equal to 120 mu mol/L).Methods-In this population-based study, cardiovascular risk factors were determined in 1017 patients (551 men and 466 women) with NIDDM, aged 45 to 64 years at baseline. The patients were followed up for 7 pears with respect to stroke events.Results-During the follow-up period, 31 NIDDM patients (12 men [2.2%] and 19 women [4.1%]) died from stroke and 114 NIDDM patients (55 men [10.0%] and 59 women [12.7%]) had a fatal or nonfatal stroke. The incidence of stroke increased significantly by quartiles of serum uric acid levels (P295 mu mol/L) was significantly associated with the risk of fatal and nonfatal stroke by Cox regression analysis (hazard ratio, 1.93 [1.30 to 2.86]; P=.001). This association remained statistically significant even after adjustment for all cardiovascular risk factors (hazard ratio, 1.91 [1.24 to 2.94[; P=.003).Conclusions-Our results indicate that hyperuricemia is a strong predictor of stroke events in middle-aged patients with NIDDM independently of other cardiovascular risk factors.