原发性高血压患者血尿酸与代谢综合征和冠状动脉病变关系

Relation between serum uric acid and metabolic syndrome and coronary artery disease in essential hypertension.

目的探讨原发性高血压患者血尿酸与代谢综合征和冠状动脉病变的关系。方法 232例原发性高血压患者经冠状动脉造影分为冠状动脉病变组124例和非冠状动脉病变组108例。结果冠状动脉病变组年龄、糖尿病、三酰甘油和血尿酸均较非冠状动脉病变组高,冠心病的严重程度与血尿酸有显著的相关性(P=0.015)。在控制其它心血管病危险因素后,血尿酸并不是冠状动脉病变独立的危险因素(P=0.151);性别分析,女性血尿酸有作为冠状动脉病变独立危险因素的趋势(P=0.062),但未达到统计学意义。最高四分位数的血尿酸水平与冠状动脉病变危险性增加有相关趋势[比值比(OR)=2.52,P=0.075],但也未达到统计学意义。血尿酸与代谢综合征及女性糖尿病密切相关。结论未治疗的原发性高血压患者血尿酸与代谢综合征和冠状动脉病变的严重程度相关,但不是冠心病独立的危险因素,血尿酸增加可能只是胰岛素抵抗的标志。

Objective To assess the relationship between serum uric acid (SUA)and metabolic syndrome and coronary artery disease(CAD).Methods 232 untreated subjects with essential hypertension were divided into two groups(CAD and no CAD)by coronary angiography.All subjects were free of myocardial infarction,cardiomyopathy,valvular disease, atrial fibrillation,aortic dissection,and renal disease.Results Compared to no CAD group,age,diabetes,triglycerides and SUA in CAD group were higher.There was a significant association between SUA and the severity of CAD (P=0. 015).However,after adjustment for concomitant risk factors of cardiovascular disease,SUA was not an independent risk factor of CAD(P=0.151).In sex-specific analysis,there was a trend of SUA to be an independent risk factor of CAD in women(P=0.062),but it was no statistic significance.The highest quartile level of $UA tended to be associated with increased risk for CAD,but it was not statistically significant either(OR=2.52,P=0.075).SUA was closely associated with metabolic syndrome and diabetes in woman.Conclusion In untreated patients with essential hyperteusion,SUA was associated with metabolic syndrome and the severity of CAD,but it is not an independent risk factor of CAD,the raised SUA may be only a marker of insulin resistance.