尿酸与代谢综合征及颈动脉粥样硬化的关系

目的研究尿酸与代谢综合征(MS)的关系,及其对颈动脉粥样硬化的影响,为动脉粥样硬化性心血管疾病的防治提供临床依据。方法MS诊断依据2005年国际糖尿病联盟的标准将2232例患者分为两组:MS组(1199例)和非MS组(1033例),在排除高尿酸血症前后,比较两组间年龄、尿酸、腰围、血压、血糖、血脂情况,应用彩色多普勒超声检测颈动脉内膜中层厚度(IMT)。结果MS组高尿酸血症检出率明显高于非MS组,排除高尿酸血症后,MS组与非MS组尿酸水平无明显差异(P>0.01),尿酸是MS的独立危险因素(OR=1.002,95%CI:1.001～1.004);MS组IMT明显高于非MS组(P<0.01);尿酸未进入IMT的回归方程。结论MS及高尿酸血症检出率呈同步升高;尿酸可能仅仅是MS,但不是颈动脉粥样硬化的独立危险因素。

The relationship between serum uric acid concentration,metabolic syndrome and carotid atherosclerosis

Objective To investigate the relationship between serum uric acid concentration(UA),metabolic syndrome(MS) and carotid atherosclerosis.Methods 2 232 patients were divided into metabolic syndrome group(MS group)and non-metabolic syndrome group according to the International Diabetes Federation(IDF) criteria.Carotid intima-media thickness(IMT) was measured by echocardiography for all patients.Independent association of UA with MS and IMT was assessed in all patients.Results The rates of MS and hyperuricemia were 53.7% and 24.2% in all patients respectively.The prevalence rate of hyperuricemia was higher in MS patients(29.0%) than in non-MS patients(18.6%).Excluding hyperuricemia patients(540 patients),there was no significant difference of UA between two groups(P>0.01).UA was one of independent risk factors for MS(OR=1.002,95%CI:1.001-1.004).IMT was significantly higher in MS group than non-MS group(P<0.01).UA was found to be not associated with IMT independently.Conclusions The prevalence rates of MS and hyperuricemia increased at the same time.UA may be one of the independent risk factors for the MS but not be that for carotid atherosclerosis.