Hyperuricemia and the risk for coronary heart disease morbidity and mortality a systematic review and dose-response meta-analysis.
Hyperuricemia and the risk for coronary heart disease morbidity and mortality a systematic review and dose-response meta-analysis.
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DOI：
10.1038/srep19520
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发表时间：
2016-01-27
影响因子：
4.6
通讯作者：
Tang Z
中科院分区：
文献类型：
--
作者：
Li M;Hu X;Fan Y;Li K;Zhang X;Hou W;Tang Z
关于高尿酸血症和冠心病（CHD）之间的关联存在相当大的争议。因此，我们对前瞻性研究进行了系统回顾和剂量反应荟萃分析来检验这一争议。根据成人血清尿酸水平进行的前瞻性队列研究符合冠心病的相对风险 (RR) 和 95% 置信区间 (CI)。使用随机效应模型来计算汇总风险估计。搜索产生了 29 项前瞻性队列研究（n = 958410 名参与者）。高尿酸血症与冠心病发病率（调整后的 RR 1.13；95% CI 1.05 至 1.21）和死亡率（调整后的 RR 1.27；95% CI 1.16 至 1.39）风险增加相关。尿酸水平每增加 1mg/dl，CHD 死亡率的汇总多变量 RR 为 1.13（95% CI 1.06 至 1.20）。剂量反应分析表明，每 dl 尿酸水平增加 1 毫克，冠心病死亡率的综合 RR 为 1.02（95% CI 0.84 至 1.24），男性间无异质性（P = 0.879，I2 = 0%），而男性间无异质性（P = 0.879，I2 = 0%），而无异质性则为 2.44（95% CI 1.69 至 3.54）。女性之间的异质性（P = 0.526，I2 = 0%）。与高尿酸血症相关的冠心病风险增加在大多数亚组中是一致的。高尿酸血症可能会增加冠心病事件的风险，尤其是女性冠心病死亡率。
Considerable controversy exists regarding the association between hyperuricemia and coronary heart disease (CHD). Therefore, we performed a systematic review and dose-response meta-analysis of prospective studies to examine the controversy. Prospective cohort studies with relative risks (RRs) and 95% confidence intervals (CIs) for CHD according to serum uric acid levels in adults were eligible. A random-effects model was used to compute the pooled risk estimate. The search yielded 29 prospective cohort studies (n = 958410 participants). Hyperuricemia was associated with increased risk of CHD morbidity (adjusted RR 1.13; 95% CI 1.05 to 1.21) and mortality (adjusted RR 1.27; 95% CI 1.16 to 1.39). For each increase of 1 mg/dl in uric acid level, the pooled multivariate RR of CHD mortality was 1.13 (95% CI 1.06 to 1.20). Dose-response analysis indicated that the combined RR of CHD mortality for an increase of 1 mg uric acid level per dl was 1.02 (95% CI 0.84 to 1.24) without heterogeneity among males (P = 0.879, I2 = 0%) and 2.44 (95% CI 1.69 to 3.54) without heterogeneity among females (P = 0.526, I2 = 0%). The increased risk of CHD associated with hyperuricemia was consistent across most subgroups. Hyperuricemia may increase the risk of CHD events, particularly CHD mortality in females.