社区无动脉粥样硬化性心血管病史人群血清尿酸浓度与肱-踝脉搏波传导速度的关系

Relationship between serum concentration of uric acid and brachial-ankle pulse wave velocity in commu⁃nity population without atherosclerotic cardiovascular disease

目的研究社区无动脉粥样硬化性心血管病史人群血清尿酸浓度与肱-踝脉搏波传导速度(brachial ankle pulse wave velocity,baPWV)的关系。方法本研究是一个横断面研究,2015年6月至2017年12月在广东社区连续入选18岁以上人群,均接受人口问卷调查、体格检查、尿酸浓度和baPWV检查,根据尿酸浓度进行四分位分组,并根据baPWV检查结果分为动脉硬化组(baPWV≥1 400 cm/s)和正常组(baPWV<1 400 cm/s)。采用单变量和多变量逻辑回归分析尿酸浓度与baPWV和动脉硬化的关系。结果共入选907例[男589(64.94%)]研究对象,年龄(50.97±9.36)岁,其中动脉硬化患者400例(44.10%)。动脉硬化患者尿酸浓度显著高于正常人,差异有统计学意义[(4.56±1.24)mg/dL vs.(4.03±1.21)mg/dL,P<0.001]。当以尿酸作为连续变量时,在调整年龄、性别、体质量指数、收缩压、空腹血糖、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇、C-反应蛋白、吸烟、饮酒、高血压和糖尿病后,尿酸浓度(OR=3.75,95%CI:1.54~9.14,P=0.004)与动脉硬化密切相关;当尿酸作为分类变量时,以第一分位作为对照,多变量调整后第二、三和四分位与动脉硬化的危险度分别为2.47(95%CI:1.36~4.50,P=0.003),2.80(95%CI:1.35~5.85,P=0.006)和4.85(95%CI:1.79~13.16,P=0.002)(趋势P<0.001)。结论社区无动脉粥样硬化性心血管病史人群血清尿酸浓度与baPWV密切相关,可能是动脉硬化的独立危险因素。

Objectives To explore the relationship between serum concentration of uric acid and brachial ankle pulse wave velocity(baPWV)in community general population without atherosclerotic cardiovascular disease.Methods This was a cross-sectional study.All participants aged≥18 years and were enrolled from Guangdong community from June 2015 to December 2017.Data including demographics,physical examination,uric acid and baPWV detection were collected.The participants were classified into increased atherosclerosis group(≥1400 cm/s)and normal group(<1400 cm/s)according to baPWV and were classified into quartile groups according to serum concentration of uric acid.Unitivariate and multivariate Logistic regression were used to analyze the association of serum concentration of uric acid with baPWV and atherosclerosis.Results A total of 907[mean age(50.97±9.36)years]participants were enrolled,and among of them male population and atherosclerosis were 589(64.94%)and 400(44.10%),respectively.Serum concentration of uric acid were significantly higher in atherosclerosis group compared to normal group[(4.56±1.24)mg/dL vs.(4.03±1.21)mg/dL,P<0.001].When uric acid was treated as a continuous variable,uric acid significantly associated with atherosclerosis(OR=3.75,95%CI:1.54-9.14,P=0.004),after adjusting for age,gender,systolic blood pressure,body mass index,C-reactive protein,fasting blood glucose,blood lipids,smoking,alcohol consumption,hypertension and diabetes.When uric acid was treated as a categorical variable,using the first quintile as referent,the risk of atherosclerosis for participants in the second,third and fourth quartiles were 2.47(95%CI:1.36-4.50;P=0.003),2.80(95%CI:1.35-5.85,P=0.006)and 4.85(95%CI:1.79-13.16,P=0.002)(trend P<0.001).Conclusions Serum concentration of uric acid in the community without atherosclerotic cardiovascular disease closely related to baPWV,which may be an independent risk factor for arteriosclerosis.