华东地区成人高血压人群中血尿酸水平与臂踝脉搏波传导速度的关联性分析
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摘要
目的了解华东农村地区高血压人群中血尿酸水平与臂踝脉搏波传导速度(brachial-ankle pulse wave velocity,baPWV)的相关性,并进一步探索可能影响两者关系的危险因素。方法本研究是于2013年7～9月在连云港市赣榆县和东海县、安庆枞阳和望江县进行的一项横断面研究。检测研究人群的血尿酸水平,并进行baPWV测定,采用多元线性回归分析来评估两者间关系。结果 4278名成年高血压患者最终纳入本研究,平均年龄为(65. 2±7. 4)岁,baPWV水平为(1 835. 1±383. 4) cm/s。多元线性回归分析结果显示,调整年龄、性别等危险因素后,血尿酸水平与baPWV呈现正相关关系(每标准差(standard deviation,SD)增加(β=20. 5 cm/s,95%CI:8. 5～32. 5,P=0. 001)。按照血尿酸水平进行三等分组时,相较于第一等分组患者(<277μmol/L),第三等分组患者(≥349μmol/L)的baPWV水平增加(β=51. 2 cm/s,95%CI:23. 8～78. 6,P=0. 001)。分层分析结果发现,在收缩压(systolic blood pressure,SBP)≥140 mm Hg人群中,血尿酸水平与baPWV具有更强的关联(交互P值=0. 001)。结论华东农村地区高血压人群的血尿酸水平与baPWV呈现正相关关系,血压控制不佳(SBP≥140 mm Hg)人群具有更强的关联。
Objective To investigate the association between serum uric acid and brachial-ankle pulse wave velocity( baPWV) levels and to examine any possible effect modifiers among hypertensive patients in rural areas of Eastern China. Methods This cross-sectional study was conducted in Lianyungang and Anqing Cities from July to September 2013. Hypertensive patients with serum uric acid and baPWV measurements were included in this study. Multivariate linear regression was used to assess the relationship between serum uric acid levels and baPWV. Results Finally,a total of 4 278 participants were included in this study. The mean age was 65. 2( standard deviation( SD) : 7. 4) years and the mean value of baPWV levels were 1835. 1( SD: 383. 4) cm/s. Regression analysis showed that there is a positive correlation between serum uric acid and baPWV levels( per SD increment,β = 20. 5 cm/s,95% CI:8. 5-32. 5,P = 0. 001. When uric acid was categorized in tertiles,a significantly higher baPWV level was found in participants in tertile 3( ≥349μmol/L)( β = 51. 2 cm/s,95% CI: 23. 8-78. 6,P = 0. 001),compared with those in tertile 1( < 277 μmol/L). Furthermore,the serum uric acid-baPWV association was significantly stronger in those systolic blood pressure( SBP) ≥140 mm Hg( vs. < 140 mm Hg; p-interaction = 0. 001). Conclusion There is a positive relationship between uric acid levels and baPWV among hypertensive patients,especially in those with higher SBP levels.
Objective To investigate the association between serum uric acid and brachial-ankle pulse wave velocity( baPWV) levels and to examine any possible effect modifiers among hypertensive patients in rural areas of Eastern China. Methods This cross-sectional study was conducted in Lianyungang and Anqing Cities from July to September 2013. Hypertensive patients with serum uric acid and baPWV measurements were included in this study. Multivariate linear regression was used to assess the relationship between serum uric acid levels and baPWV. Results Finally,a total of 4 278 participants were included in this study. The mean age was 65. 2( standard deviation( SD) : 7. 4) years and the mean value of baPWV levels were 1835. 1( SD: 383. 4) cm/s. Regression analysis showed that there is a positive correlation between serum uric acid and baPWV levels( per SD increment,β = 20. 5 cm/s,95% CI:8. 5-32. 5,P = 0. 001. When uric acid was categorized in tertiles,a significantly higher baPWV level was found in participants in tertile 3( ≥349μmol/L)( β = 51. 2 cm/s,95% CI: 23. 8-78. 6,P = 0. 001),compared with those in tertile 1( < 277 μmol/L). Furthermore,the serum uric acid-baPWV association was significantly stronger in those systolic blood pressure( SBP) ≥140 mm Hg( vs. < 140 mm Hg; p-interaction = 0. 001). Conclusion There is a positive relationship between uric acid levels and baPWV among hypertensive patients,especially in those with higher SBP levels.
引文
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[10]张军霞,刁波,袁紫林,等.尿酸通过TLR2炎症信号通路上调脂肪细胞肾素-血管紧张素表达[J].中华内分泌代谢杂志,2018,(8):684-689. DOI:10. 3760/cma. j. issn. 1000-6699.2018. 08. 011.Zhang J,Diao B,Yuan Z,et al. Uric acid up-regulates renin-angiotensin system via TLR2 inflammatory signaling pathway in adipocytes[J]. Chin J Endocrinol Metab,2018,(8):684-689.DOI:10. 3760/cma. j. issn. 1000-6699. 2018. 08. 011.
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[13]瞿心远,季文,王新亚,等.高血压与中心性肥胖对心脑血管疾病的联合作用[J].中华疾病控制杂志,2018,22(7):703-707. DOI:10. 16462/j. cnki. zhjbkz. 2018. 07. 012.Zhai X,Ji W,Wang X,et al. Combined effects of hypertension and central obesity on the risk of cardio-cerebrovascular diseases[J]. Chin J Dis Control Prev,2018,22(7):703-707. DOI:10.16462/j. cnki. zhjbkz. 2018. 07. 012.
[14] Cicero AF,Rosticci M,Fogacci F,et al. High serum uric acid is associated to poorly controlled blood pressure and higher arterial stiffness in hypertensive subjects[J]. Eur J Intern Med,2017,37:38-42. DOI:10. 1016/j. ejim. 2016. 07. 026.
[15]邢慧媛,刘琰,赵艾,等.吸烟、饮酒和膳食因素对高尿酸血症人群中高血压的影响[J].中华疾病控制杂志,2018,22(6):555-559. DOI:10. 16462/j. cnki. zhjbkz. 2018. 06. 004.Xing H,Liu Y,Zhao A,et al. Effects of smoking,drinking and dietary factors on hypertension in subjects with hyperuricemia[J].Chin J Dis Control Prev,2018,22(6):555-559. DOI:10. 16462/j. cnki. zhjbkz. 2018. 06. 004.
[2]孙欣,李广义,李远洋,等.动脉硬化无创检测研究进展[J].中国医疗设备,2015,30(10):14-17. DOI:10. 3969/j. issn.1674-1633. 2015. 10. 004.Sun X,Li G,Li Y,et al. Progress in Arterial Stiffness Non-invasive Measurement[J]. China Medical Devices,2015,30(10):14-17. DOI:10. 3969/j. issn. 1674-1633. 2015. 10. 004.
[3] Zhao G,Huang L,Song M,et al. Baseline serum uric acid level as a predictor of cardiovascular disease related mortality and allcause mortality:a meta-analysis of prospective studies[J]. Atherosclerosis,2013,231(1):61-68. DOI:10. 1016/j. atherosclerosis. 2013. 08. 023.
[4] Bae JS,Shin DH,Park PS,et al. The impact of serum uric acid level on arterial stiffness and carotid atherosclerosis:The Korean Multi-Rural Communities Cohort study[J]. Atherosclerosis,2013,231(1):145-151. DOI:10. 1016/j. atherosclerosis. 2013.08. 017.
[5] Shin JY,Lee HR,Shim JY. Significance of high-normal serum uric acid level as a risk factor for arterial stiffness in healthy Korean men[J]. Vasc Med,2012,17(1):37-43. DOI:10. 1177/1358863X11434197.
[6] Cicero AF,Salvi P,D'Addato S,et al. Association between serum uric acid,hypertension,vascular stiffness and subclinical atherosclerosis:data from the Brisighella heart Study[J]. J Hypertens,2014,32(1):57-64. DOI:10. 1097/HJH. 0b013e328365b916.
[7] Chen L,Zhu W,Mai L,et al. The association of metabolic syndrome and its components with brachial-ankle pulse wave velocity in south China[J]. Atherosclerosis,2015,240(2):345-350.DOI:10. 1016/j. atherosclerosis. 2015. 03. 031
[8]周珊珊.青年男性高血压患者血尿酸水平与动脉硬化关系[J].健康必读旬刊,2013(4):298.Zhou SS. Relationship between serum uric acid levels and arteriosclerosis in young male patients with hypertension[J]. Health Required,2013(4):298.
[9] Varghese JF,Patel R,Ucs Y. Novel insights in the metabolic syndrome-induced oxidative stress and inflammation-mediated atherosclerosis[J]. Curr Cardiol Rev,2018,14(1):4-14. DOI:10.2174/1573403X13666171009112250
[10]张军霞,刁波,袁紫林,等.尿酸通过TLR2炎症信号通路上调脂肪细胞肾素-血管紧张素表达[J].中华内分泌代谢杂志,2018,(8):684-689. DOI:10. 3760/cma. j. issn. 1000-6699.2018. 08. 011.Zhang J,Diao B,Yuan Z,et al. Uric acid up-regulates renin-angiotensin system via TLR2 inflammatory signaling pathway in adipocytes[J]. Chin J Endocrinol Metab,2018,(8):684-689.DOI:10. 3760/cma. j. issn. 1000-6699. 2018. 08. 011.
[11] Saji N,Kimura K,Shimizu H,et al. Silent brain infarct is independently associated with arterial stiffness indicated by cardio-ankle vascular index(CAVI)[J]. Hypertens Res,2012,35(7):756-760. DOI:10. 1038/hr. 2012. 20.
[12]贺玉泉,李迪,杨萍.血清尿酸水平与高血压患者血管内皮功能的相关性研究[J].中国实验诊断学,2010,14(8):1220-1222.He YQ,Li D,Yang P. Association of serum uric acid and function of blood vessel endothelium in hypertensive patients[J].Chin J Lab Diagn,2010,14(8):1220-1222.
[13]瞿心远,季文,王新亚,等.高血压与中心性肥胖对心脑血管疾病的联合作用[J].中华疾病控制杂志,2018,22(7):703-707. DOI:10. 16462/j. cnki. zhjbkz. 2018. 07. 012.Zhai X,Ji W,Wang X,et al. Combined effects of hypertension and central obesity on the risk of cardio-cerebrovascular diseases[J]. Chin J Dis Control Prev,2018,22(7):703-707. DOI:10.16462/j. cnki. zhjbkz. 2018. 07. 012.
[14] Cicero AF,Rosticci M,Fogacci F,et al. High serum uric acid is associated to poorly controlled blood pressure and higher arterial stiffness in hypertensive subjects[J]. Eur J Intern Med,2017,37:38-42. DOI:10. 1016/j. ejim. 2016. 07. 026.
[15]邢慧媛,刘琰,赵艾,等.吸烟、饮酒和膳食因素对高尿酸血症人群中高血压的影响[J].中华疾病控制杂志,2018,22(6):555-559. DOI:10. 16462/j. cnki. zhjbkz. 2018. 06. 004.Xing H,Liu Y,Zhao A,et al. Effects of smoking,drinking and dietary factors on hypertension in subjects with hyperuricemia[J].Chin J Dis Control Prev,2018,22(6):555-559. DOI:10. 16462/j. cnki. zhjbkz. 2018. 06. 004.