血尿酸水平与亚临床靶器官损害的相关性研究

Relationship between serum uric acid level and subclinical target organ damage

目的·探究血尿酸水平与亚临床靶器官损害的相关性。方法·入选体检人群333例,测定其血尿酸,根据尿酸水平分为高尿酸组(85例)、正常组(248例);测定其亚临床靶器官损害指标包括肾小球滤过率、左室重量指数等。通过相关分析及多元线性回归分析探讨尿酸水平与亚临床靶器官损害的关系。结果·高尿酸组的收缩压(P=0.006)、舒张压(P=0.000)、血肌酐(P=0.000)、左室重量指数(P=0.028)显著高于正常组,肾小球滤过率显著低于正常组(P=0.000)。Pearson相关性分析显示,血尿酸水平与收缩压(r=0.149,P=0.007)、舒张压(r=0.269,P=0.000)、左室重量指数(r=0.172,P=0.002)、血肌酐(r=0.569,P=0.000)显著正相关,血尿酸水平与肾小球滤过率显著负相关(r=-0.383,P=0.000)。进一步校正性别、年龄、体质量指数后,与舒张压仍呈显著正相关(r=0.170,P=0.013),与肾小球滤过率呈显著强负相关(r=-0.332,P=0.000)。进一步校正血压后,与肾小球滤过率仍呈显著强负相关(r=-0.291,P=0.000)。多元线性回归分析显示,血尿酸与舒张压呈独立正相关(β=0.162,P=0.000),血尿酸与肾小球滤过率呈独立负相关(β=-0.058,P=0.004)。结论·血尿酸与舒张压呈独立正相关,血尿酸与肾小球滤过率呈独立负相关。

Objective · To explore the correlation between serum uric acid level and subclinical target organ damage. Methods · A cohort of 333 patients were recruited at the Department of Examination Center of Ruijin Hospital North in July 2017, who were divided into two groups, normal (n=248) and high levels (n=85, males >420 μmol/L, females >360 μmol/L) of serum uric acid. Subclinical target organ damage indexes included glomerular filtration rate (eGFR), left ventricular mass index (LVMI) and other indicators. Results · Systolic pressure (P=0.006), diastolic pressure (P=0.000), serum creatinine (P=0.000) and LVMI (P=0.028) in the high uric acid group were significantly higher than those in the normal uric acid group, and eGFR was significantly lower than that of the control group (P=0.000). Pearson correlation analysis showed that the serum uric acid level was significantly correlated with systolic pressure (r=0.149, P=0.007), diastolic pressure (r=0.269, P=0.000), LVMI (r=0.172, P=0.002) and serum creatinine (r=0.569, P=0.000), and negatively correlated with glomerular filtration rate (r=-0.383, P=0.000). After adjusting to sex, age, and BMI, there was a significant positive correlation with diastolic pressure (r=0.170, P=0.013), and a significant negative correlation with glomerular filtration rate (r=-0.332, P=0.000). After further adjusting to blood pressure, there was a significant negative correlation with glomerular filtration rate (r=-0.291, P=0.000). Multivariate linear regression analysis showed that serum uric acid was independent of diastolic pressure and glomerular filtration rate (β=0.162, P=0.000;β=-0.058, P=0.004). Conclusion · Serum uric acid is positively correlated with diastolic blood pressure, and is negatively correlated with glomerular filtration rate.