绝经期后女性高尿酸血症与动脉粥样硬化的关系

Relationship of hyperuricemia with carotid atherosclerosis in postmenopausal women

目的探讨绝经期后女性高尿酸血症与颈动脉粥样硬化的关系。方法连续人选2012年1月至7月于大连医科大学附属第一医院体检时发现血脂异常并同意行颈部血管超声检查的绝经期后女性患者196例。其中，156例经颈部血管彩色多普勒超声诊断为颈动脉粥样硬化、斑块形成（A组），其余40例无粥样硬化（B组）。比较两组的年龄、血压、合并疾病情况、体质量指数（BMI），雌二醇（E2）、血糖、血肌酐、血脂水平和尿酸水平的差异。结果A组血尿酸水平明显高于B组[（455．32±54．67）vs（374．32±45．76）μmol／L，P=0．02]；A组低密度脂蛋白胆固醇水平明显高于B组[（4．41±0．84）vs（4．11±0．81）mmol／L，P=0．04]。尿酸水平与甘油三酯和低密度脂蛋白胆固醇水平呈正相关（r=0．315，r=0．214），与高密度脂蛋白胆固醇呈负相关（r=-0．243）。A组中高尿酸组低密度脂蛋白胆固醇和甘油三酯水平高于正常尿酸组[（4．49±0．81）vs（4．26±0．79）mmol／L，P=0．04；（2．66±0．34）w（2．45±0．39）mmol／L，P=0．02]；HDL-C水平低于正常尿酸组[（1．09±0．39）w（1．21±0．40）mmol／L，P=0．03]。结论绝经后女性颈动脉粥样硬化的发生，除目前已知与血脂异常密切相关外，也与尿酸水平密切相关。

Objective To investigate the relationship between hyperuricemia and carotid artery atherosclerosis in postmenopausal women. Methods A total of 196 consecutive postmenopausal patients with dyslipidemia and receiving carotid artery ultrasonography in First Affiliated Hospital, Dalian Medical University from January to June 2012 were enrolled in this study. Among them, 156 patients were diagnosed with atherosclerosis and carotid atherosclerotic plaque （group A） identified by color Doppler ultrasound examination, and the other 40 cases had no atheroselerosis （group B）. The age, blood pressure, body mass index （BMI）, blood estradiol （E2）, blood glucose, blood lipid and uric acid levels were compared between the two groups. Results There was no significant difference in the age, blood pressure, blood glucose, blood levels of triglyeerides and high-density lipoprotein, BMI value and E2 levels between the two groups. However, group A had significantly higher uric acid [（455.32±54.67） vs （374.32 ±45.76）μmol/L, P = 0.02] and low-density lipoprotein cholesterol （LDL-C） [（4.41± 0.84） vs （4.11 ±0.81）mmol/L, P=0.04] than group B. Uric acid levels showed positive correlation with triglyeerides and LDL-C respectively （r = 0.315, r = 0.214）, but negative correlation with high-density lipoprotcin cholesterol （HDL-C） （r=-0.243）. Among the 124 patients with hyperuricemia out of group A, they had significantly higher levels of LDL-C [（4.49 ±0.81） vs （4.26± 0.79）mmol/L, P = 0.04] and triglycerides [（2.66 ± 0.34） vs （2.45± 0.39）mmol/L, P =0.02], and significantly lower level of HDL-C [（1.09 ± 0.39） vs （1.21 ±0.40）mmol/L, P = 0.03] when compared with the patients with normal uric acid level from group A. Conclusion Besides blood lipid, uric acid level is closely related with the carotid atherosclerosis in postmenopausal women.