尿酸与高血压前期的关系

Serum Uric Acid and Prehypertension

背景高尿酸血症常见于高血压患者,且已有实验和临床研究表明尿酸与原发性高血压的发病有关,但对于血清尿酸水平和高血压前期的关系报道,相对较少。目的研究不同尿酸水平和高血压前期的关系。方法采用整群抽样的方式于2005-2006年间在全国9省市选取有代表性的城市,农村社区进行横断面调查。从中选取了7839名非患高血压和其他心血管疾病的人群,并根据尿酸的四分位数将该人群分成4组(<209、209～262、262～324、>324μmol/L),同时为了进一步分析不同性别下尿酸和高血压前期的关系,根据不同性别下尿酸的四分位数将人群分成不同的组别:男性(<250、250～306、306～366、>366μmol/L);女性(<1 93、193～236、236～285、>285μmol/L)。利用多元 logistic 回归方法分析尿酸水平与发生高血压前期的之间的关系。结果不同尿酸水平下,患有高血压前期的发生率是不同的.且随着尿酸水平的升高而逐渐增加(P<0.01),同样的趋势也出现在女性人群中(P=0.04),但男性未见显著趋势(P=0.66);相关分析发现无论男性还是女性,尿酸与舒张压(DBP)、空腹血糖(FPG)、肌酐,体质量指数(BMI),三酰甘油(TG),总胆固醇(TC)均呈强正相关(P<0.01);Logistic 多元回归分析发现,在调整了年龄、性别、吸烟、饮酒、肌酐、低密度脂蛋白胆固醇(LDL-C),高密度脂蛋白胆固醇(HDL-C),TG,TC,FPG,BMI等危险因素后,尿酸的最高四分位组患高血压前期的危险是尿酸最低四分位组的1.3倍(95%CI,1.1～1.5,P=0.04),且患高血压前期的危险随着尿酸水平的增加而增加(P=0.03)。结论非患高血压和其他心血管疾病的人群中,尿酸水平的升高可能与高血压前期发生率的增加有关,且这种作用独立于其他多重危险因素。

Background Previous experimental and clinical studies have proved that elevated serum uric acid increased risk for developing hypertension. Whereas, there are a paucity of information on the relationship between serum uric acid and prehypertension. Objective The purpose of this research is to evaluate the association between the serum uric acid and prehypertension. Method A cohort of seven thousand eight hundred thirty-nine subjects without hypertension and other cardiovascular diseases were recruited from a cross-sectional study in urbanand rural place in 9 provinces during 2005-2006. Based on serum uric acid （〈209, 209-262, 262--324, 〉324 umol/L for overall population, 〈250, 250--306, 306--366, 〉366 umol/L for male, 〈193, 193--236, 236--285, 〉285 umol/L for female）, people were categorized into quartiles. The odds ratio for prehypertension was calculated with the lowest quartile as the reference. Results The prevalence of prehypertension increased with increasing uric acid in total population （P〈0.01）, similar trend was found in female population （P=0.04） but not in male participants（P=0.66）. Serum uric acid was related with gender, DBP, FPG, creatinine, body mass index （BMI）, TG, TC （all P〈0. 01）. However, after adjusting for age, sex, smoking, drinking, LDL-C, HDL-C, serum creatinine, triglyceride, total cholesterol, FPG, BMI, the multivariable odds ratio （OR） for prehypertension comparing quartile 4 of uric acid（〉324 umol/L） to lowest quartile 1（〈209 umol/L） was 1.3（95% CI. 1. 1-1.5, P=0.04） , P trend=0. 03. Conclusion Serum uric acid independently associated with the increasing rate of prehypertension in people without hypertension and cardiovascular disease.