体检人群血清尿酸浓度与心血管病危险因素的关系

目的分析本院体检人群血清尿酸浓度及其与心血管疾病危险因素的关系。方法记录在本院进行健康体检的24 965人的性别、年龄,测量受检者的身高、体质量、体质量指数、收缩压、舒张压,检测他们的血清尿酸、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、空腹血糖浓度。进一步分析血清尿酸浓度及其影响因素的关系。结果宁波市人群血清尿酸浓度(312.01±89.26)μmol/L,男性血清尿酸值明显高于女性,差异有统计学意义[(359.71±75.71)μmol/L vs.(244.95±58.40)μmol/L,P0.001]。各心血管危险因素在控制其他危险因素后与血清尿酸浓度进行偏相关分析:年龄(r=0.0272,P0.001)、体质量指数(r=0.191,P0.001)、舒张压(r=0.130,P0.001)、总胆固醇(r=0.047,P0.001)、三酰甘油(r=0.025,P0.001),均与血清尿酸浓度呈正相关;而空腹血糖(r=-0.081,P0.001)、低密度脂蛋白胆固醇(r=-0.045,P0.001)、高密度脂蛋白胆固醇(r=-0.110,P0.001)均与血清尿酸浓度呈负相关;收缩压与血清尿酸浓度无相关性(r=-0.001,P0.857)。结论本院体检人群血清尿酸浓度较高,血清尿酸浓度升高与多种心血管危险因素相关。     

山东沿海居民血尿酸水平与心血管疾病危险因素的关系

目的 探讨山东沿海地区居民的血清尿酸水平与心血管疾病危险因素之间的相关性.方法 实验设计采用随机整群抽样分层设计的方法 ,调查研究了4 988名山东沿海地区居民一般生活、健康及营养状况,采用白动生化分析仪和电化学发光分析仪检测受试者的空腹血尿酸、血脂、胰岛素等指标.结果 在男女受试者中,其心血管危险因索如收缩压、舒张压、肌酐、总胆固醇(TC)、甘油三酯(TG)、腰围以及体重指数(BMI)都随着血清尿酸值的升高而增加,而高密度脂蛋白胆固醇水平逐级降低.女性受试者的稳态模型评估的胰岛素抵抗指数(HOMA.IR)逐级升高,而男性受试者的升高不明显.与血尿酸<280μmol/L组相比.血尿酸280～319、320～349 >1350 μmol/L 3组女性受试者发生高血压的相对危险度(DR)分别为1.54、1.88和2.70,而发生代谢综合征(MS)的OR分别为2.29、4.15和4.96;在男性,与血尿酸<280μmoL/L组相比,血尿酸320～379、380～419和≥420 μmol/L 3组受试者发生MS的OR分别为I.41、1.87和3.27,血尿酸/>420 μmol/L组发生高血压的OR为1.52.调整混杂因素后,Logistic回归分析显示,在男性和女性巾高尿酸均可视为高血压的独立危险因素.结论 较高的血清尿酸水平与心血管疾病的发生和发展密切相关,在临床实践中应予重视.     

血清超敏C反应蛋白与心血管危险因素的关系探讨

目的在中年自然人群中探讨血清超敏C反应蛋白(hs-CRP)与心血管危险因素的关系。方法对388例"宫内发育与成人疾病"队列人群的身高、体重、血压、血糖、血脂及血清hs-CRP等进行测定。用SPSS10.0软件进行数据统计分析。结果由低至高的血清hs-CRP四等分组的心血管危险因素体重指数(BMI)、血压、空腹血糖、高密度脂蛋白胆固醇(HDL-C)组间差异有统计学意义(P0.001);总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL-C)的组间差异也有统计学意义(P0.05),四组心血管危险因素聚集检出率分别为5.7%,14.3%,28.6%,51.4%(P0.001)。结论血清hs-CRP与心血管危险因素(BMI、血压、血糖和血脂)呈正相关关系。     

脑梗死患者血清尿酸水平与颈动脉粥样硬化斑块危险因素的关系

目的探讨脑梗死患者血清尿酸水平与颈动脉粥样硬化斑块危险因素的关系。方法选择脑梗死患者181例,根据颈动脉超声检查分为无斑块组59例,稳定斑块组48例,易损斑块组74例。检测血清尿酸水平,双功能彩色多普勒超声检测颈动脉内膜中层厚度及斑块性质。结果易损斑块组血清尿酸水平明显高于无斑块组和稳定斑块组[(396.26±126.84)μmol/L vs(353.75±126.25)μmol/L,(325.77±94.08)μmol/L,P<0.05]。血清尿酸与颈动脉内膜中层厚度和TG呈正相关,与HDL-C呈负相关(P<0.01)。血清尿酸是脑梗死患者颈动脉易损斑块的独立危险因素(OR=1.006,95%CI:1.002¹.101,P=0.002)。结论血清尿酸是脑梗死患者动脉粥样硬化和斑块形成的危险因素,是易损斑块形成的可能独立危险因素。     

胰岛素抵抗与心血管产现危险因素聚集性关系研究

The coexistence of multiple cardiovascular risk factors in the same individual is called a clustering of cardiovascular risk factors. Many studies have shown that this phenomenoa is associated with a increased morbility of cardiovascular disease, and insulin resistance may be the common link between the risk factors. This study was designed to link the clustering of cardiovascular risk factors with insulin resistance. Using a new insulin sensitivity index [-log (fasting serum Glu x Ins)] to evaluate the insulin resistance, we investigated the relationship between the insulin sensitivity and cardiovascular risk factors in 106 patients with hypertension or coronary heart disease and 32 normal subjects. The normal group without cardiovascular risk factors was selected as controls. The individual with 2 risk factors were defined as having mild clustering, and those with > or = 3 risk factors as severe clustering. As the number of risk factors increased from 1 to > or = 3, the insulin sensitivity index increased from -1.69 +/- 0.24, -1.95 +/- 0.17 to -2.14 +/- 0.21 respectively. The insulin resistance was positively correlated with serum uric acid in women (P < 0.05), but not in men (P > 0.05). The insulin sensitivity was more decreased in postmenopausal than in pre-menopausal women. The insulin sensitivity index was -2.23 +/- 0.39 vs -1.73 +/- 0.13 (P < 0.05). The insulin resistance is associated with a clustering of risk factors of cardiovascular disease, more cluste-ring, more resistant.     

尿酸与心血管事件

半个世纪以前 ,人们已经发现高尿酸血症与心血管疾病之间存在着一定的联系。自从 195 1年Gertler等[1] 首次提出尿酸与冠心病之间可能存在复杂的相互作用以来 ,许多流行病学和临床研究结果证实了血尿酸增高与心血管疾病相关联[2 4] ,高尿酸血症与心血管事件之间的关系受到人们的高度关注。尿酸是人体内嘌呤类化合物代谢的最终产物 ,从肾脏排出体外。血尿酸升高与嘌呤的过量合成和肾脏对尿酸的排出减少有关。流行病学和临床研究结果显示 ,肥胖、高血压、高甘油三酯血症、过量酒精摄入是高尿酸血症发病的危险因素 ,其患病率在不同种族和地区…     

血清超敏C反应蛋白与心血管危险因素的关系

目的：探讨血清超敏C反应蛋白（hs—CRP）与心血管危险因素的关系。方法：对,388例健康成人（男223例,女165例,年龄47～53岁）的身高、体重、血压、心电图、血糖、血脂及血清hs～CRP等进行测定。结果：由低至高的血清hs—CRP四等分组（〈2．1mg／L,2．1～5．0mg／L,5．1～8．0mg／L,〉8．0mg／L）的心血管危险因素体重指数、血压、空腹血糖、高密度脂蛋白-胆固醇（HDL—C）组间差异非常显著（F=7．63～22．46,P均〈0．001）,总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白-胆固醇（LDL—c）的组间差异有显著性（F=2．89～8．88,P分别为0．031,0．022,0．015）,四组心血管危险因素聚集检出率分别为32．3％,48．9％,58．0％,79．4％．差异有显著性（x^2=28．12,P〈0．001）。结论：血清hs—CRP与心血管危险因素（体重指数、血压、血糖和血脂）有关。     

非传统危险因素与冠心病的关系

目的探讨非传统危险因素血清尿酸(SUA)、总胆红素(TBIL)和血浆纤维蛋白原(FIB)水平与冠心病的关系。方法选择经冠状动脉造影确诊的冠心病患者220例和非冠心病患者60例;冠心病组根据冠脉狭窄严重程度又分为药物治疗组59例和介入治疗组161例。分别测定各组SUA、TBIL和FIB水平。结果冠心病组的SUA、FIB水平高于非冠心病组,TBIL水平低于非冠心病组(P<0.05)。SUA越高,FIB越高,TBIL越低,冠心病的患病率越高(P<0.05)。介入治疗组与药物治疗组比较,SUA、TBIL水平有统计学差异(P<0.05),FIB水平无统计学差异(P>0.05)。结论 SUA、FIB水平升高和TBIL水平下降是冠心病的危险因素,对存在高尿酸血症、高纤维蛋白原血症或胆红素代谢紊乱的患者给予必要的药物和行为干预,有可能会预防和减少心血管事件的发生。     

控制糖尿病心血管危险因素研究进展

在我国．2型糖尿病的发病率已经上升到接近4％．预计总患病人数4千余万。华人可能是糖尿病的好发人群之一，根据IDF(国际糖尿病联盟)的文献，香港地区的发病率为12％．在全球国家／区域性统计中排名首位．新加坡11％排第四，这可能是现代西方化的生活方式和华人遗传素质相结合的结果。在美国少数人种也是糖尿病的好发人群。随着发展中国家现代化的进展，专家估计发展中国家的发病率将以较快的速度增长．其危害将逐步全球化。     

心血管危险因素及疾病与动脉弹性

心血管病危险因素 ,通过损害血管的结构和功能导致心、脑、肾等器官并发症产生心脑血管疾病及事件。反映动脉弹性的主要指标及检测方法有多种 ,早期检测动脉的结构及功能异常对于预测血管的亚临床及临床疾病非常重要。1　临床上检测动脉弹性指标的方法1 1　脉搏波传导速度 (pulsewavevelocity ,PWV) [1 ,2 ] :PWV主要反映一段血管壁功能 ,可以在不同的动脉段进行 ,如颈动脉—股动脉、肱动脉—桡动脉、股动脉—胫动脉等。常代表大动脉的结构及功能。PWV大 ,表示动脉硬度高、顺应性差。反之 ,则血管硬度低、顺应性佳 ,并常伴有脉压的增大…     

U-shaped association of serum uric acid with cardiovascular disease risk scores and the modifying role of sex among Chinese adults

Background and aimsSerum uric acid (SUA) is involved in the development of cardiovascular disease (CVD). However, information on the dose-response relationship between SUA and CVD is limited in the Chinese population. This study aimed to investigate the potential nonlinear dose-response association of SUA with CVD risk in a Chinese population and to explore the effect of sex on these associations.Methods and resultsCross-sectional data, from 6252 Chinese adults aged 30–74 years who participated in the China Health and Nutrition Survey 2009, were stratified by SUA deciles. The 10-year risk of CVD was determined using the Framingham risk score. A restricted cubic spline (RCS) was incorporated into the logistic models to assess the nonlinear relationship between SUA and CVD. Among the participants, 65%, 20%, and 15% had low, moderate, and high 10-year CVD risks, respectively. Compared with the reference SUA strata of 225 to <249 μmol/L, CVD risk was significantly increased at SUA ≥294 μmol/L, with adjusted ORs ranging from 2.39 (1.33–4.33) to 4.25 (2.37–7.65). An increasingly higher nonsignificant CVD risk was found at SUA <225 μmol/L and showed a nonlinear U-shaped association. In the fitted RCS model, an approximate U-shaped association between SUA and CVD risk scores was found in women, but this significant nonlinear relationship was not found in men.ConclusionThis study showed that both lower and higher SUA levels were associated with a higher 10-year CVD risk among Chinese adults, forming a U-shaped relationship, and this pattern was particularly pronounced for women.     

血尿酸与冠心病的相关性分析

目的分析研究冠心病和血尿酸的形成、扩散与患者治疗、恢复之间的关系。方法抽取近年来在我院给予血尿酸检测的冠心病病人180例（实验组）,并且再次抽取在这期间在我院进行常规体检的健康人群180例（对照组）当做对比分析观察。结果实验组病人的血尿酸含量：（421．23±43．52）μmol／L;对照组的血尿酸含量：（362．45±40．57）μmol／L,两组间差异具有统计学意义（P〈0．05）;然而心绞痛和陈旧性心肌梗死病人的血尿酸水平明显优于急性心肌梗死以及对照组病人,其差异具有统计学意义（P〈0．05）;急性心肌梗死病人的血尿酸水平（平均）和对照组差异不具有统计学意义（P〈0．05）。结论冠心病的形成、扩散是造成患者血尿酸的浓度升高的重要因素,对于冠心病病人应该采取定期对血尿酸进行检测,这样对及时预防这种疾病的发生具有非常大的帮助,对病人的生活质量起到至关重要的作用．具有临床推广价值应用。     

Association of uric acid with cardiovascular risk in Brazilian children and adolescents

Background and aimHyperuricemia in adults is associated with cardiovascular risk factors. However, there is less data regarding this association in children and adolescents. Our purpose was to determine association between serum uric acid (SUA) and cardiovascular risk.Methods and resultsA fasting blood sample was collected from 1750 participants aged 6–17 years enrolled in a social project and public schools in Espírito Santo, Brazil. Internal cut-offs were generated to define high SUA (≥90th percentile of SUA concentration for sex and age group). Body mass index percentile (pBMI), body fat percentage (BFP) and muscle mass were determined by bioimpedance. Data are given as mean ± standard deviation. High SUA was associated with overweight/obesity (OR 3.7 CI 95% 2.7–5.0), high waist circumference (WC) (OR 3.9 CI 95% 2.9–5.4), low HDL (OR 2.0 CI 95% 1.5–2.8), high blood pressure (BP) (OR 1.8 CI 95% 1.1–3.2), high BFP (OR 4.1 CI 95% 2.7–6.4), metabolic syndrome (MetS) (OR 3.6 CI 95% 1.8–7.1) and insulin resistance (OR 1.7 CI 95% 1.1–2.7). Individuals in the fourth quartile of SUA, compared to those in the first quartile, showed higher age, pBMI, WC, BFP and muscle mass. Using a reference value of 5.5 mg/dL, the prevalence of hyperuricemia in the sample was 10.3% (CI 95% 8.9–11.7%).ConclusionHigher SUA values are associated with higher cardiovascular risk in childhood and adolescence. The main cardiovascular risk factors associated with hyperuricemia were overweight/obesity, high WC, dyslipidemia, high BFP, high BP, insulin resistance and MetS.     

Baseline serum uric acid level as a predictor of cardiovascular disease related mortality and all-cause mortality: A meta-analysis of prospective studies

Objective

Serum uric acid (SUA) levels have been used to predict cardiovascular and all-cause mortality event, but the data have yielded conflicting results. We investigated whether SUA was an independent predictor for cardiovascular or all-cause mortality with prospective studies by meta-analysis.

Methods

Pubmed and Embase were searched without language restrictions for publications available till April 2013. Only prospective studies on cardiovascular or all-cause mortality related to SUA levels were included. Pooled adjust relative risk (RR) and corresponding 95% confidence intervals (CI) were calculated separately for the highest vs. lowest category or the lowest vs. middle category.

Results

For the highest SUA, eleven studies with 172,123 participants were identified and analyzed. Elevated SUA increased risk of all-cause mortality (RR 1.24; 95% CI 1.09–1.42) and cardiovascular mortality (RR 1.37; 95% CI 1.19–1.57). Subgroup analyses showed that elevated SUA significantly increase the risk of all-cause mortality among men (RR 1.23; 95% CI 1.08–1.42), but not in women (RR 1.05; 95% CI 0.79–1.39). Risk of cardiovascular mortality appeared to be more pronounced among women (RR 1.35; 95% CI 1.06–1.72). The association between extremely low SUA and mortality was reported in three studies; we did not perform a pooled analysis because of high degree of heterogeneity in these studies.

Conclusions

Baseline SUA level is an independent predictor for future cardiovascular mortality. Elevated SUA appears to significantly increase the risk of all-cause mortality in men, but not in women. Whether low SUA levels are predictors of mortality is still inconclusive.     

Elevated serum uric acid and risk of cardiovascular or all-cause mortality in maintenance hemodialysis patients: A meta-analysis

Background and aimsStudies have shown inconsistent results about the association between serum uric acid (SUA) levels and mortality in hemodialysis patients. We performed this meta-analysis to determine whether higher SUA values comprised a risk factor of cardiovascular or all-cause mortality in maintenance hemodialysis patients.Methods and resultsPubmed, Embase and the Cochrane library were searched up to August 31, 2020 for the longitudinal studies that investigated the association between the elevated SUA and cardiovascular or all-cause mortality risk in maintenance hemodialysis patients. Pooled adjusted hazard ratios (HR) and corresponding 95% confidence interval (CI) were calculated using a random-effects model. We included 10 studies with an overall sample of 264,571 patients with hemodialysis in this meta-analysis. Patients with the highest SUA were associated with a decreased risk of cardiovascular mortality (HR = 0.72, 95% CI 0.59–0.87) compared with patients with the lowest SUA after adjustment for potential confounders in a random effects model. Moreover, for each increase of 1 mg/dl of SUA, the overall risks of all-cause and cardiovascular mortality decreased by 6% and 9%, respectively (HR = 0.94, 95% CI 0.90–0.99; HR = 0.91, 95% CI 0.89–0.94).ConclusionElevated SUA levels are strongly and independently associated with lower risk of cardiovascular mortality in maintenance hemodialysis patients. More designed studies, especially randomized controlled trials, should be conducted to determine whether high SUA levels is an independent risk factor of all-cause mortality in hemodialysis patients.     

冠心病患者尿酸浓度变化的临床意义

目的:通过对冠心病患者的尿酸水平进行监测,阐明尿酸作为冠心病危险因素的价值。方法:于冠状动脉造影证实的冠心病患者79例(男39例,女40例);正常对照组61例(男26例,女35例),测定其总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C),脂蛋白a[LP(a)]及尿酸水平。结果:冠心病患者TC、TG、LDL-C、HDL-C水平与对照组无明显差异,LP(a)、尿酸水平较对照组明显升高(P<0.05),患者冠状动脉病变范围越大、程度越严重,其血浆尿酸和LP(a)水平越高。结论:血浆尿酸合并LP(a)水平升高与冠心病有关。     

中老年人血尿酸水平与非酒精性脂肪性肝病的相关性研究

目的:研究中老年人群血尿酸水平与非酒精性脂肪性肝病(NAFLD)的相关性。方法 :采取整群抽样方法,对上海市嘉定社区2 519名40岁以上常住居民进行问卷调查、体格检查,同时采血进行血尿酸、血糖、血脂、肝功能、肾功能检测,以及上腹部彩色多普勒超声检查。NAFLD的诊断依据高分辨率超声扫描结果。按照血尿酸水平四分位数将研究人群分为Q1、Q2、Q3、Q4四组,并对其各项代谢指标进行分析。结果:NAFLD组的血尿酸水平显著高于非NAFLD组[(319.6±92.3)比(272.8±88.8)μmol/L,P<0.05)。结论:上海城镇中老年人群NAFLD患病风险随着血尿酸水平升高而增加。