2型糖尿病患者血尿酸水平与肾脏早期损害关系的研究

探讨2型糖尿病患者的血尿酸水平与肾脏早期损害指标尿白蛋白尿肌酐比(ACR)之间的关系.高尿酸组中ACR的超标率显著高于尿酸正常组(P＜0.01).ACR与尿酸水平呈正相关(P＜0.01).多元线性回归表明ACR是尿酸的主要影响因素.2型糖尿病患者合并高尿酸者存在ACR超标,更易出现肾脏早期损害.

Abstract：

The association of serum uric acid ( SUA ) and urine albumin-to-creatinine ratio ( ACR ) in patients with type 2 diabetes mellitus was explored. The ACR abnormal rate was higher in hyperuricemia group( P＜0.01 ). ACR level was positively correlated with SUA( P＜0.01 ). The general linear model showed that SUA was a risk factor in ACR. Patients with hyperuricemia and type 2 diabetes mellitus were apt to have abnormal ACR and develop early renal damage.     

男性2型糖尿病血尿酸与颈动脉粥样硬化的相关性研究

目的 探讨男性2型糖尿病患者血尿酸(SUA)水平和颈动脉粥样硬化的关系.方法 收集男性2型糖尿病患者579例,根据SUA水平四分位数分为:95~250、251~302、303~363和364~658 μmol/L 4个组.检测体重指数、血压、血脂、尿素氮、肌酐、HbA1C等相关指标,高分辨血管外超声检测颈动脉血管斑块厚度及颈动脉内膜中层厚度,统计学分析SUA与上述指标的关系.结果 男性2型糖尿病患者随着SUA水平升高颈动脉粥样硬化的检出率逐渐增高(P＜0.05),且斑块厚度也随之逐渐增高(P＜0.05),但与颈动脉内膜中层的厚度无关(P＞0.05).男性2型糖尿病患者年龄、SUA及HbA1C均为颈动脉粥样硬化的危险因素.结论 SUA与颈动脉粥样硬化发生发展可能有关.

Abstract：

Objective To investigate the relationship between the level of serum uric acid(SUA) and carotid atherosclerosis in male patients with type 2 diabetes mellitus(T2DM). Methods A collection of 579 male T2DM patients with or without carotid atherosclerosis were grouped based on quartiles of SUA. Age, SUA, smokers, duration, body mass index(BMI), blood pressure, total cholesterol(TC), triglyceride(TG), high-density lipoprotein cholesterol(HDL-C), low-density lipoprotein cholesterol(LDL-C), blood urea nitrogen(BUN), creatinine(Cr), and HbA1C were determined in all subjects. The plaques in carotid arteries and intima-media thickness(IMT) were measured with high-resolution ultrasound. Results BMI, systolic and diastolic blood pressures, TG, and Cr showed a gradual increase, while HDL-C and HbA1C showed a gradual decrease according to the higher SUA quartiles in male T2DM(P＜0.05). Nevertheless, the detectable rates of smokers, duration, age, TC, LDL-C, and BUN had no relationships with the SUA quartiles(P＞0.05). The detectable rate of carotid atherosclerosis and the thickness of carotid plaque were positively associated with the levels of SUA in male patients with T2DM(P＜0.05). However, intima-media thickness of carotid arteries did not illustrate the correlation with the levels of SUA in male T2DM patients(P＞0.05). Age, HbA1C, and SUA were independent factors of carotid atherosclerosis in these patients by logistic regression(P＜0.05). Conclusion The levels of SUA seems to be associated with the occurrence and development of carotid atherosclerosis in male patients with T2DM.     

超敏C反应蛋白水平与血压昼夜波动程度的关系

目的 探讨血浆C反应蛋白水平与血压昼夜波动程度的关系. 方法入选高血压患者82例,正常血压者79例.采用免疫荧光色谱法检测血浆超敏C反应蛋白水平,同时用24 h动态血压仪监测入选者血压水平和血压变异性.采用多元线性回归,校正年龄、性别、体质指数、血糖、血脂、吸烟史、基线血压等各影响因素,分析C反心蛋白水平与血压昼夜波动的关系. 结果 (1)高血压组白天、夜间和24 h收缩压变异性均高于对照组(P＜0.01、P＜0.01和P＜0.05),舒张压变异性亦高于对照组(均为P＜0.05),而夜间收缩压、舒张压和平均动脉压下降率均低于对照组(分别为P＜0.01、P＜0.05和P＜0.05);(2)高血压组血浆C反应蛋白高于对照组分别为(5.44±1.78)mg/L与(3.03±0.72)mg/L,差异有统计学意义(P＜0.01);(3)高血压组白天、夜间和24 h 3个时段的舒张压变异性均与C反应蛋白水平呈正相关(分别为r=0.492,P＜0.001;r=0.240,P=0.048;r=0.271,P=0.030).多元线性回归分析结果显示,上述3个时段的舒张压变异性对C反应蛋白水平具有预测作用(r=0.660,决定系数R2=0.436;回归模型F=11.597,P＜0.001).(4)正常血压组各时段的血压变异性与C反应蛋白水平无相关性. 结论高血压患者血压变异性、血浆C反应蛋白水平均显著高于正常血压患者,而夜间血压下降率低于正常血压者,且高血压患者血浆C反应蛋白水平与昼夜血压的波动程度,特别是舒张压的波动程度密切相关.

Abstract：

Objective To explore the association between CRP and circadian variation of blood pressure in both hypertensive and normotensive old population.Methods The 82 patients with essential hypertension (EH) and 79 normotensive adults were enrolled in this study. Serum high sensitive CRP (hsCRP) level was tested by fluorescence immunoassay technology. The 24-hour ambulatory monitor of the level and variability of blood pressure was carried out. Multivariable linear regression models were run to adjust the age, gender, body mass index, blood sugar, blood fat,smoking history and baseline blood pressure for analyzing the association between hsCRP and circadian variation of blood pressure.Results ( 1 ) The variability of systolic blood pressure during daytime,nighttime and 24-h our periods were higher in EH group than in control group (P＜0.01 or P＜0. 05), the variabilities of diastolic blood pressure were also significantly higher than in control group (P＜0. 05), the dipping ratios of nocturnal systolic, diastolic and mean artery pressure were all less than in contrast group (all P＜0.05). (2) The hsCRP was obviously higher in EH group than in control group [(5.44± 1.78)mg/L vs. (3.03±0. 72) mg/L, P＜0. 01]. (3) The hsCRP had positive associations with diastolic blood pressure variability during daytime (r= 0. 492, P＜0. 001 ), nighttime (r=0.240, P=0.048), and 24-hour (r=0.271, P=0.030). The variability in diastolic blood pressure predic ted the level of hs CRP(r=0.660, R2=0.436, P＜0.001). (4) In control group, no significant association was found between CRP and variation of blood pressure.Conclusions The BP variability and serum CRP in EH patients are obviously higher than in normotensive patients,however, the nocturnal BP dipping ratio is less than in normotensive patients. Furthermore, the level of serum hsCRP in EH patients is positively associated with the variation of blood pressure, especially for variation of diastolic blood pressure.     

健康体检人群血尿酸与非酒精性脂肪肝的相关性研究

目的 观察非酒精性脂肪性肝病(NAFLD)在不同血尿酸水平人群中的分布,以探讨血尿酸与NAFLD的相关性.方法 以本院体检中心5 230名健康体检者为研究对象,测量其身高、体重、血压,空腹取血行肝肾功能、血脂、血糖、肝炎相关指标检查,同时行心电图、腹部超声、胸部X线等检查.NAFLD诊断依据2006年中华肝脏病学会和酒精性肝病学组所规定的NAFLD诊断标准.结果 除高血糖人群外,随血尿酸水平增高,男性和女性超重或肥胖、高血压、血脂异常以及代谢综合征(MS)检出率均逐步升高(P＜0.05或P＜0.01).除男性MS人群外,无论有无超重或肥胖、高血糖、高血压、血脂紊乱,NAFLD检出率均随血尿酸增高明显升高,尤其当血尿酸＞333 μmol/L(男)或＞233 μmol/L(女)时(P＜0.05或P＜0.01),但女性高血糖和血脂紊乱人群,最低尿酸水平组人群NAFLD的检出率亦较高(P＜0.05).对无任何MS相关组分的人群研究发现,在相同血尿酸水平下,男性NAFLD检出率明显高于女性(P＜0.01),女性NAFLD检出率在血尿酸＞233 μmol/L时迅速升高(P＜0.01);无论男女NAFLD检出率均随血尿酸增高而增高(P＜0.05);logistic回归分析显示,性别、体重指数、血糖、甘油三酯、低密度脂蛋白胆固醇、尿酸分级是NAFLD的高危因素,OR值分别为2.500、1.344、1.292、1.279、1.244和1.256.结论 高尿酸血症是NAFLD的高危因素,与NAFLD的发病密切相关.

Abstract：

Objective To evaluate the relationship between hyperuricemia and nonalcoholic fatty liver disease(NAFLD) by observing the prevalence of NAFLD among healthy individuals with different levels of serum uric acid.Methods The data of 5 230 persons from medical centers for health examination were analyzed,such as height,weight,blood pressure,blood lipids,blood sugar, hepatitis-related markers, and abdominal color Doppler ultrasound examination were conducted in the fasting state.The diagnosis of NAFLD was made according to the diagnostic criteria adopted by China Institute of Liver Disease and Alcoholic Liver Disease Group.Results The incidences of overweight or obesity, hypertension,hyperlipidemia, and metabolic syndrome were raised with serum uric acid greater than 333 μmol/L in male and＞233 μmol/L in female subjects(P＜0.05 or P＜0.01). Excluding the metabolic syndrome in male subjects, the incidence of NAFLD was increased with serum uric acid,＞333 μmol/L in males or ＞233 μmol/L in females(P＜0.05 or P＜0.01). In further studies with subjects without any metabolic syndrome, the detection rate of NAFLD was higher in males than in females at the same serum uric acid level(P＜0.01). Logistic regression analysis showed that sex, body mass index, blood glucose, and triglyceride, low-density lipoprotein cholesterol, uric acid grading were risk factors of NAFLD(OR 1.344, 2.500, 1.292, 1.279, 1.244, 1.256 respectively).Conclusion A high serum uric acid level is associated with an increased risk of NAFLD.     

Estimated net endogenous acid production and risk of prevalent and incident hypertension in community-dwelling older people

AIM: To investigate the associations of dietary acidbase load with prevalent and incident hypertension in community-living Chinese older adults in Hong Kong.METHODS: Participants aged ≥ 65 years participating in a cohort study examining the risk factors for osteoporosis completed a validated food frequency questionnaire(FFQ) at baseline between 2001 and 2003.Estimated net endogenous acid production(NEAP) was calculated using Frassetto's method based on the diet's protein to potassium ratio derived from the FFQ.Prevalent and 4-year incident hypertension was defined as systolic blood pressure ≥ 140 mm Hg and/or diastolic blood pressure ≥ 90 mm Hg and/or self-reported use of anti-hypertensive medications.Multivariable logistic regression was used for cross-sectional analysis(n =3956) to assess the association between estimated NEAP and prevalent hypertension,and for longitudinal analysis(n = 795) on its association with 4-year incident hypertension,with adjustment for various potential socio-demographic and lifestyle factors.RESULTS: Median estimated NEAP of the participants was 47.7(interquartile range: 36.2,60.9) g/m Eq.Participants in the highest quartile of energy-adjusted estimated NEAP was associated with increased likelihood of prevalent hypertension than those in the lowest quartile of energy-adjusted estimated NEAP [multivariable OR = 1.66(95%CI: 1.22 to 2.26,P trend = 0.002)].No significant association was observed between energy-adjusted estimated NEAP and risk of incident hypertension.CONCLUSION: A high dietary acid load was independently associated with an increased likelihood of prevalent hypertension in ambulant older Chinese people in Hong Kong.The longitudinal analyses failed to show any causal relationship between dietary acid load and hypertension in this population.     

The L-shaped association between superoxide dismutase levels and blood pressure in older Chinese adults: community-based,cross-sectional study

BACKGROUND As an antioxidant,serum superoxide dismutase(SOD)have been found to be associated with hypertension.METHODS The data were derived from the Chinese Longitudinal Healthy Longevity Survey(CLHLS),a prospective cohort study in China.We explored the association between serum SOD and blood pressure(BP)using multivariable correction analysis in an older Chinese population.RESULTS We observed a significantly gradual downward trend in the association between serum SOD levels and diastolic BP(DBP)in participants with lower serum SOD levels(<58 IU/mL),while no associations were observed between serum SOD levels and DBP in participants with higher serum SOD levels(>58 IU/mL).Similar results showed a significant gradual downward trend in associations between serum SOD levels and the risk of diastolic hypertension only at SOD<58 IU/mL.Multiple linear regression analysis suggested that serum SOD was negatively correlated with DBP(Sβ=-0.088,P<0.001)but not with SBP(Sβ=0.013,P=0.607).Multiple logistic regression analysis suggested that serum SOD was independently associated with the risk of diastolic hypertension(OR=0.984,95%CI:0.973?0.996,P=0.010)but not with the risk of systolic hypertension(OR=1.001,95%CI:0.990?1.012,P=0.836))after adjusting for relevant confounding factors.Serum SOD levels(<58 IU/mL,>58 IU/mL)were an effect modifier of the association between serum SOD and DBP(interaction P=0.0038)or the risk of diastolic hypertension(interaction P=0.0050).CONCLUSIONS Our study indicated for the first time that there was an L-shaped association between serum SOD levels and the risk of diastolic hypertension in the older Chinese population.     

应用超声检查评价高血压患者血管僵硬度与心功能的关系

Objective To assess the relationship between arterial stiffness and heart function in patients with hypertension using ultrasonography. Methods A total of 167 patients with hypertension and 165 controls were enrolled, and the parameters of arterial stiffness and heart function were measured and calculated. The results were analyzed and compared. Results The ratio of peak early-diastolic mitral orifice flow velocity and peak early-diastolic mitral annular velocity in left ventricular posterior wall (E/e), and Tei index were significantly higher in hypertension group than in controls(E/e: 10.92±3.14 vs. 7.70 ±1.56, Teiindex: 0.58±0.13 vs. 0.45±0.09, both P＜0.05), but there was no significant difference in ejection fraction (EF) between the two groups. In hypertension group, the parameters of arterial stiffness including β value, pressure-strain elastic modulus (Ep), pulse wave velocity (PWVβ) and arterial compliance were 11.0±5.2, (172.6±83.8)kPa, (7.8±1.6) m/s and (0.6±0.2) mm2/ kPa. In control group, the corresponding data were 7.5±3.0, (97.1±45.4) kPa, (5.9±1.3) m/s and (0.8±0.3) mm2/kPa. There were significant differences between the two groups (all P＜0.05). The E/e was positively correlated with Ep and PWVβ(γ=0.316 and 0.296, both P＜0.05). The Tei index was positively correlated with Ep,augmentation index (AI) and PWVβ(γ=0.278, 0.300 and 0.323, P＜0.05-0.01). There was no significant correlation between EF and arterial stiffness. Conclusions The arterial stiffness and damage of heart function can result from hypertension. The arterial stiffness can be one of monitoring indexes for the heart function damage in early time.     

应用超声检查评价高血压患者血管僵硬度与心功能的关系

Objective To assess the relationship between arterial stiffness and heart function in patients with hypertension using ultrasonography. Methods A total of 167 patients with hypertension and 165 controls were enrolled, and the parameters of arterial stiffness and heart function were measured and calculated. The results were analyzed and compared. Results The ratio of peak early-diastolic mitral orifice flow velocity and peak early-diastolic mitral annular velocity in left ventricular posterior wall (E/e), and Tei index were significantly higher in hypertension group than in controls(E/e: 10.92±3.14 vs. 7.70 ±1.56, Teiindex: 0.58±0.13 vs. 0.45±0.09, both P＜0.05), but there was no significant difference in ejection fraction (EF) between the two groups. In hypertension group, the parameters of arterial stiffness including β value, pressure-strain elastic modulus (Ep), pulse wave velocity (PWVβ) and arterial compliance were 11.0±5.2, (172.6±83.8)kPa, (7.8±1.6) m/s and (0.6±0.2) mm2/ kPa. In control group, the corresponding data were 7.5±3.0, (97.1±45.4) kPa, (5.9±1.3) m/s and (0.8±0.3) mm2/kPa. There were significant differences between the two groups (all P＜0.05). The E/e was positively correlated with Ep and PWVβ(γ=0.316 and 0.296, both P＜0.05). The Tei index was positively correlated with Ep,augmentation index (AI) and PWVβ(γ=0.278, 0.300 and 0.323, P＜0.05-0.01). There was no significant correlation between EF and arterial stiffness. Conclusions The arterial stiffness and damage of heart function can result from hypertension. The arterial stiffness can be one of monitoring indexes for the heart function damage in early time.     

Relationship and significance between anti-b2-glycoproteinⅠantibodies and platelet activation state in patients with ulcerative colitis

AIM:To study the relationship between anti-b2-glycoprotein Ⅰ (ab2GPⅠ) antibodies and platelet activation state in patients with ulcerative colitis (UC) and its significance. METHODS:Peripheral blood samples were collected from 56 UC patients (34 males and 22 females, aged 43.5 years, range 21-66 years), including 36 at active stage and 20 at remission stage, and 25 sex-and age-matched controls. The level of ab2GPⅠ was measured by ELISA. The platelet activation markers, platelet activation complex-Ⅰ (PAC-Ⅰ) and P-selectin (CD62P) were detected by flow cytometry. RESULTS:The A value for IgG ab2GPⅠ in the active UC group was 0.61 ± 0.13, significantly higher than that in the remittent UC and control groups (0.50 ± 0.13 and 0.22 ± 0.14, P < 0.01). There was a significant difference between the two groups (P < 0.01). The A value for IgM ab2GPⅠ in the active and remittent UC groups was 0.43 ± 0.13 and 0.38 ± 0.12, significantly higher than that in the control group (0.20 ± 0.12, P < 0.01). However, there was no significant difference between the two groups (P > 0.05). The PAC-Ⅰ positive rate for the active and remittent UC groups was 30.6% ± 7.6% and 19.6% ± 7.8% respectively, significantly higher than that for the control group (6.3% ± 1.7%, P < 0.01). There was a significant difference between the two groups (P < 0.01). The CD62P positive rate for the active and remittent UC groups was 45.0% ± 8.8% and 31.9% ± 7.8% respectively, significantly higher than that for the control group (9.2% ± 2.7%, P < 0.01). There was a significant difference between the two groups (P < 0.01). In the active UC group, the more severe the state of illness was, the higher the A value for IgG ab2GPⅠ was, and the positive rate for PAC-I and CD62P was positively correlated with the state of illness (Fab2GPⅠ = 3.679, P < 0.05;FPAC-I (%) = 5.346, P < 0.01;and FCD62P (%) = 5. 418, P < 0.01). Meanwhile, in the same state of illness, the A value for IgG ab2GPⅠ was positively correlated to the positive rates for PAC-I and CD62P. CONCLUSION:ab2GPⅠ level, platelet activation state and their relationship of them are closely correlated with the pathogenesis and development of UC.     

Relationship and significance between anti-β2-glycoprotein I antibodies and platelet activation state in patients with ulcerative colitis

AIM:To study the relationship between anti-β2-glycoproteinⅠ(aβ2GPⅠ) antibodies and platelet activation state in patients with ulcerative colitis (UC)and its significance.METHODS:Peripheral blood samples were collected from 56 UC patients (34 males and 22 females,aged 43.5 years,range 21-66 years),including 36 at active stage and 20 at remission stage,and 25 sex-and age-matched controls.The level of aβ2GPⅠwas measured by ELISA.The platelet activation markers,platelet activation complex-I (PAC- I) and P-selectin (CD62P) were detected by flow cytometry.RESULTS:The A value for IgG aβzGPⅠin the active UC group was 0.61±0.13,significantly higher than that in the remittent UC and control groups (0.50±0.13 and 0.22±0.14,P＜0.01).There was a significant difference between the two groups (P＜0.01).The A value for IgM aβ2GPⅠin the active and remittent UC groups was 0.43±0.13 and 0.38±0.12,significantly higher than that in the control group (0.20±0.12,P＜0.01).However,there was no significant difference between the two groups (P＞0.05).The PAC-I positive rate for the active and remittent UC groups was 30.6%±7.6% and 19.6%±7.8% respectively,significantly higher than that for the control group (6.3%±1.7%,P＜0.01).There was a significant difference between the two groups (P＜0.01).The CD62P positive rate for the active and remittent UC groups was 45.0%±8.8% and 31.9%±7.8% respectively,significantly higher than that for the control group (9.2%±2.7%,P＜0.01).There was a significant difference between the two groups (P＜0.01).In the active UC group,the more severe the state of illness was,the higher the A value for IgG aβ2GPⅠwas,and the positive rate for PAC-I and CD62P was positively correlated with the state of illness (Faβ2GPⅠ= 3.679,P＜0.05;FPAC-I (%) = 5.346,P＜0.01;and FCD62P (%) = 5.418,P＜0.01).Meanwhile,in the same state of illness,the A value for IgG aβ2GPⅠwas positively correlated to the positive rates for PAC-I and CD62P.CONCLUSION:aβ2GPⅠlevel,platelet activation state and their relationship of them are closely correlated with the pathogenesis and development of UC.     

心血管高危患者踝臂指数与血尿酸水平的相关性分析

目的探讨心血管高危患者踝臂指数与血尿酸水平的相关性。方法选取高血压和(或)糖尿病患者363例,将单纯原发性高血压189例作为高血压组、原发性高血压合并2型糖尿病123例作为合并组和单纯2型糖尿病51例作为糖尿病组,均常规治疗,检测患者踝臂指数(ABI)、血尿酸和其他心血管疾病危险因素,并应用偏相关分析血尿酸、ABI与其他临床指标相关性。结果 3组收缩压、舒张压、TG、HDL-C、糖化血红蛋白(HbA1c)比较,差异有统计学意义(P<0.05)。高血压组和糖尿病组ABI高于合并组(1.12±0.09和1.11±0.07 vs 0.93±0.11,P=0.012)。校正高血压、糖尿病病史、年龄、性别、体质量指数、TG、TC、HDL-C、LDL-C、HbA1c、收缩压、舒张压等的影响因素后,ABI与血尿酸呈负相关(r=-0.235,P=0.012)。结论心血管高危患者的ABI与血尿酸可能存在相关性。     

Association between serum uric acid level and hypertension in a Chinese elderly rural population

Previous studies have examined the association between elevated serum uric acid (SUA) level and hypertension; however, the association in the Chinese elderly is still uncertain. A cross-sectional study was performed in a rural district of Beijing. A total of 2,397 participants (967 men and 1,430 women) completed the survey. The SUA levels of participants were categorized into four levels using the quartiles (P25, P50, and P75) as cutoff values. Participant was diagnosed as hyperuricemia if the SUA level was ≥417 μmol/L (male) or ≥357 μmol/L (female). Hypertension was defined as systolic blood pressure (BP) ≥140 mmHg and/or diastolic BP ≥90 mmHg and/or receiving antihypertensive drug treatment. Multiple logistic regression was used to estimate the association between SUA and hypertension. We found that higher SUA level was associated with the increased risk of hypertension in both sexes, even after adjusting for potential confounding variables. In total, the risk for having hypertension increased by 0.3% per 1 μmol/L increment in SUA level, increased by 95% for the highest vs. lowest quartile of SUA level, and increased by 111% in the hyperuricemia patients. Moreover, we found that the association was more pronounced in the male participants. There were approximately J-shaped relationships between SUA level (quartiles) and hypertension in all age groups. Higher SUA levels are positively associated with hypertension among the Chinese rural elderly. Further studies are still required to determine the relationship between SUA level and hypertension and to explore its potential biological mechanisms underlying the gender-related association in the elderly population.

Abbreviations: CVD; cardiovascular disease; BMI: body mass index; BP: blood pressure; SUA: serum uric acid; TC: total cholesterol; TG: triglycerides; HDL-C: high-density lipoprotein; LDL-C: low-density lipoprotein; FPG: fasting blood glucose; OR: odds ratio; CI: confidence interval; SD: standard deviation     

Interaction between serum uric acid and triglycerides in relation to blood pressure

The aim of this study was to examine the independent relationship between serum uric acid (SUA) and blood pressure, and to assess their joint effects on obesity, fasting glucose and lipids. The study samples were from a community-based health examination survey in Xuzhou, Jiangsu province of China (2009). Blood pressure, body mass index, fasting glucose, lipids and SUA were measured. After excluding individuals with fasting glucose greater than 7?mmol?l(-1), a total of 8415 subjects with biomarkers available were included in the present study. Blood pressure increased with elevated SUA levels, after adjusting for age and sex. Further adjustment for fasting glucose, lipids and alcohol consumption did not change the increasing trend. The associations between uric acid and hypertension were most evident in those with highest quintiles of high-density lipoprotein cholesterol (HDL-C). In addition, the associations were significant in both men and women, and we found significant interactions between uric acid status and age on hypertension. When the joint effects were examined, we found an additive effect of triglycerides and uric acid levels on diastolic blood pressure (DBP). There was significant association between SUA and hypertension, independent of other metabolic risk factors. HDL-C levels may modify the associations between uric acid and hypertension. The effects of triglycerides and uric acid levels on DBP were additive.     

广西壮族自治区百色市高血压伴高尿酸血症患病率及其与超重血糖血脂血尿酸关系的研究

目的 探讨广西壮族自治区百色市高血压合并高尿酸血症(HUA)患病率及其与超重、血糖、血脂和血尿酸水平变化的关联性.方法 检测21 588名百色市居民身高、体质量、血压、血脂、血糖和血尿酸,进行探索性分析.采用方差分析、趋势x2检验、t检验以及Logistic回归等进行统计分析.结果 高血压患者6808例,患病率31.5％; HUA患者2592例,患病率12.0％;高血压伴HUA患者1260例,患病率5.8％.高血压伴HUA患者与血压、血尿酸正常者相比,其收缩压[分别为(151±12)、(127±6) mm Hg]、舒张压[分别为(84±10)、(72±6) mm Hg]、脉压[分别为(50±12)、(37±8) mm Hg]、体质量指数(BMI)[分别为(23.9±2.6)、(21.7±2.4) kg/m2],总胆固醇[分别为(6.0±1.3)、(5.2±1.1) mmol/L],甘油三酯[分别为(2.3±2.2)、(1.5±0.7) mmol/L],低密度脂蛋白胆固醇(LDL-C)[分别为(3.4±1.3)、(3.0±1.1) mmol/L]均明显增高(P＜0.01),高密度脂蛋白胆固醇(HDL-C)[分别为(1.2±0.4)、(1.5±0.5) mmol/L]明显降低(P＜0.01).高血压和HUA组患者,其舒张压、脉压、BMI、总胆固醇、甘油三酯和LDL-C均较健康组高(P＜0.01),HDL-C均值较健康组低(P＜0.01);血压和血尿酸水平与BMI、血糖、总胆固醇、甘油三酯、HDL-C和LDL-C均有交互性(P＜0.01或P＜0.05);血尿酸或血压水平增高者,其血压、肥胖和糖脂代谢观察指标的异常率高(P＜0.01),年龄、BMI、血糖、总胆固醇、甘油三酯和LDL-C都是高血压和HUA的独立危险因素;HUA者发生高血压的风险是血尿酸正常者的3.1倍,高血压患者HUA发病的风险是血压正常者的2.6倍.结论 百色市居民高血压和HUA患病率高,肥胖、糖脂代谢紊乱是高血压和HUA的共同病变基础,HUA与高血压可能存在着互为因果、相互作用的关系.     

老年高血压患者血尿酸水平与高血压危险因素的关系

目的研究血尿酸水平与高血压危险因素的关系,探讨血尿酸水平对高血压发生的预测价值。方法选择老年高血压患者230例(高血压组)及健康体检者202例(对照组)。根据血尿酸水平,按四分位法,将所有入选者分为≤288 μmol/L分位108例、289～333 μmol/L分位109例、334～386 μmol/L分位108例、≥387 μmol/L分位107例。分析血尿酸与高血压患病率及部分高血压危险因素是否有相关性。结果高血压组患者血尿酸水平明显高于对照组(P0.01);老年高血压患者血尿酸水平升高与体重指数、总胆固醇和高密度脂蛋白胆固醇密切相关(P0.01);老年高血压患病率与血尿酸水平同步升高;logistic回归分析显示,血尿酸水平和体重指数是老年高血压发病的独立危险因素之一(OR=1.006.95% CI:1.002～1.009,P0.05;OR=1.1 66,95% CI:1.047～1.298,P0.05)。结论高尿酸血症与多种高血压危险因素具有密切关系,是高血压发病的独立危险因素。     

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。     

宁波市人群血尿酸水平及其影响因素

目的:分析本地区不同年龄阶段人群的血尿酸水平及其影响因素。方法:记录在本院进行体检的24965人的性别、年龄,测量受检者的身高、体重、血压、进行血生化检测,按年龄进行分组,并进行统计学分析。结果:男性血尿酸水平高于女性(P<0.01)。女性血尿酸水平随年龄增长的幅度明显,各年龄组间比较均有显著性差异(P<0.01)。在50岁以下人群中血尿酸水平与年龄、性别、体重指数、舒张压、总胆固醇、甘油三酯呈正相关(P<0.01),与空腹血糖、低密度脂蛋白、高密度脂蛋白呈负相关(P<0.01)。70岁以上人群中血尿酸与年龄、性别呈正相关(P<0.05),与血糖成负相关(P<0.01)。结论:中青年人群血尿酸水平升高与多种心血管危险因素显著相关,老年人血尿酸水平的相关因素与中青年不同,在干预上应分别对待。     

非酒精性脂肪肝与高血压病发病的关系及可能机制探讨

目的：探讨非酒精性脂肪肝（NAFLD）与高血压病发病的关系和可能机制。方法：入选NAFLD的患者125例（NAFLD组）;体检正常者105例（正常对照组）。NAFLD组按血清谷丙转氨酶（ALT）水平分为两个亚组：A组（ALT≥40IU／L）60例;B组（ALT〈40IU／L）65例。测定各组空腹血糖（FBG）、血尿酸（SUA）、血脂、C反应蛋白（CRP）、血清ALT水平,检测颈动脉内膜中层厚度（IMT）。结果：①与正常对照组比较,NAFLD组高血压病发病率、血清FBG、UA、CRP、TC、TG、LDL—c水平明显升高,IMT明显增加,HDL—c水平明显降低（P均〈0．05）;与B组相比,A组SUA[（360．2±118．3）umol／L比（420．8±111．3）umol／L]水平明显升高、IMT[（0．76±0．03）mm比（1．29±0．06）mm]明显增加（P均〈0．05）;②Pearson相关分析显示,患者ALT水平与血压（收缩压及舒张压）呈正相关（r=0．419、0．381,P〈0．05）。结论：①非酒精性脂肪肝与高血压发病有关;其血谷丙转氨酶水平升高可能是促使高血压病发生的机制之一。     

Uric acid concentration as a risk marker for blood pressure progression and incident hypertension: A Chinese cohort study

ObjectiveLittle is known about serum uric acid (SUA) role for hypertension in the Asian countries with low cardiovascular events. We aimed to explore the relationship in a comprehensive Chinese cohort.MethodsParticipants in the Taiwanese Survey on Prevalences of Hypertension, Hyperglycemia, and Hyperlipidemia (TwSHHH) who were free of hypertension at baseline recruitment in 2002 (n= 3257) were evaluated for the longitudinal association between baseline SUA and blood pressure progression (BPP) and incident hypertension.ResultsDuring a mean follow-up of 5.41 years, 1119 persons (34.3%) had experienced progression to a higher blood pressure stage and 496 persons (15.2%) had developed hypertension. In multivariate analyses, the adjusted hazard ratios (HRs) [95% confidence intervals (CIs)] comparing the highest and lowest SUA quartiles were 1.78 (1.11–2.02, P for trend .004) for BPP and 1.68 (1.23–2.04, P for trend .028) for incident hypertension. The positively graded relationships between SUA concentration and blood pressure outcomes were observed in both males and females. More interestingly, a statistically significant trend for increasing risk of BPP and incident hypertension across SUA quartiles was most pronounced in participants with abdominal obesity.ConclusionWe concluded that SUA level was an independent predictor of blood pressure progression and incident hypertension in a Chinese population.