男性痛风患者血尿酸水平与血脂成分的相关性
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摘要
目的探讨男性痛风患者血尿酸(SUA)与各血脂成分的相关性。方法收集风湿免疫科310例男性痛风患者的年龄、身高、体重、血压、生活方式、疾病史及血生化资料。SUA根据中位数二分位:低水平SUA组(<525μmol/L)和高水平SUA组(≥525μmol/L)。结果高水平SUA组的总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、非高密度脂蛋白胆固醇(non-HDL-C)均高于低水平SUA组,但高密度脂蛋白胆固醇(HDL-C)浓度却低于低水平SUA组。SUA与血脂的Pearson相关分析发现SUA与TC、TG、LDL-C、non-HDL-C呈正相关(r=0.362、0.330、0.478、0.413,P均<0.001),与HDL-C呈负相关(r=-0.215,P<0.001)。多因素回归分析结果显示:高TC、TG、LDL-C、non-HDL-C水平是SUA的危险因素,而高HDL-C是SUA的保护因素。结论高SUA与血脂的代谢异常有明显的相关性,其中与LDL-C相关性较为明显,提示男性痛风患者的高尿酸血症可能易引发动脉粥样硬化,增加心血管病发生风险。
引文
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[2] Kuo CF, Grainge MJ, Zhang W, et al. Global epidemiology of gout: prevalence, incidence and risk factors[J]. Nat Rev Rheumatol,2015,11(11):649-662.
[3] Huang H, Yu B, Liu W, et al. Serum apoprotein A1 levels are inversely associated with disease activity in gout: From a southern Chinese Han population[J]. Medicine (Baltimore),2017,96(17):e6780.
[4] Wallace SL, Robinson H, Masi AT, et al. Preliminary criteria for the classification of the acute arthritis of primary gout[J]. Arthritis Rheum,1977,20(3):895-900.
[5] Liu M, He Y, Jiang B, et al. Association between Serum Uric Acid Level and Metabolic Syndrome and Its Sex Difference in a Chinese Community Elderly Population[J]. Int J Endocrinol,2014,2014:754678.
[6] Kawai T, Ohishi M, Takeya Y, et al. Serum uric acid is an independent risk factor for cardiovascular disease and mortality in hypertensive patients[J]. Hypertens Res,2012,35(11):1087-1092.
[7] Yuan HJ, Yang XG, Shi XY, et al. Association of serum uric acid with different levels of glucose and related factors[J]. Chin Med J (Engl),2011,124(10):1443-1448.
[8] 武阳丰,赵冬,周北凡,等. 中国成人血脂异常诊断和危险分层方案的研究[J]. 中华心血管病杂志,2007,35(5):428-433.
[9] Grundy SM, Cleeman JI, Merz CN, et al. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel Ⅲ guidelines[J]. Circulation,2004,110(2):227-239.
[10] 杨永娜,刘杰,郝东云,等. 非高密度脂蛋白胆固醇水平与冠心病病情的相关性分析[J]. 中国动脉硬化杂志,2017,25(10):1031-1035.
[11] Lu W, Song K, Wang Y, et al. Relationship between serum uric acid and metabolic syndrome: an analysis by structural equation modeling[J]. J Clin Lipidol,2012,6(2):159-167.
[12] Verdecchia P, Schillaci G, Reboldi G, et al. Relation between serum uric acid and risk of cardiovascular disease in essential hypertension. The PIUMA study[J]. Hypertension,2000,36(6):1072-1078.
[13] Strazzullo P, Puig JG. Uric acid and oxidative stress: relative impact on cardiovascular risk?[J]. Nutr Metab Cardiovasc Dis,2007,17(6):409-414.
[14] Su P, Liu H, Zhao Y, et al. Relationship Between Hyperuricemia and Cardiovascular Disease Risk Factors in a Chinese Population: A Cross-Sectional Study[J]. Med Sci Monit,2015,21:2707-2717.
[15] 宋宏界. 血尿酸水平与血脂的相关性研究[J]. 中国实用医药,2016,11(2):32-33.
[16] 梁文霞. 女性2型糖尿病患者不同血尿酸(SUA)水平与BMI、血压和血脂的相关性研究[J]. 中国医药导刊,2017,19(1):13-14, 18.
[17] Marotta T, Liccardo M, Schettini F, et al. Association of hyperuricemia with conventional cardiovascular risk factors in elderly patients[J]. J Clin Hypertens (Greenwich),2015,17(1):27-32.
[18] Qin L, Yang Z, Gu H, et al. Association between serum uric acid levels and cardiovascular disease in middle-aged and elderly Chinese individuals[J]. BMC Cardiovasc Disord,2014,14:26.
[19] 梁单. 急性痛风患者血尿酸水平与血脂的关系[D]. 长春:吉林大学,2008.
[20] 青玉凤,刘晶,周京国,等. 原发性痛风患者326例血尿酸、胱抑素 C和脂代谢特点分析及其临床意义[J]. 中华临床医师杂志,2013,7(7):2804-2808.
[21] Zhu Y, Hu Y, Huang T, et al. High uric acid directly inhibits insulin signalling and induces insulin resistance[J]. Biochem Biophys Res Commun,2014,447(4):707-714.
[22] Braga F, Pasqualetti S, Ferraro S, et al. Hyperuricemia as risk factor for coronary heart disease incidence and mortality in the general population: a systematic review and meta-analysis[J]. Clin Chem Lab Med,2016,54(1):7-15.
[23] Brodov Y, Behar S, Boyko V, et al. Effect of the metabolic syndrome and hyperuricemia on outcome in patients with coronary artery disease (from the Bezafibrate Infarction Prevention Study)[J]. Am J Cardiol,2010,106(12):1717-1720.