Serum Uric Acid is Associated with the Predicted Risk of Prevalent Cardiovascular Disease in a Community-dwelling Population without Diabetes

Objective To examine the association between serum uric acid levels and cardiovascular disease risk among individuals without diabetes.Methods We investigated the association between serum uric acid levels and the risk of prevalent cardiometabolic diseases, 10-year Framingham risk for coronary heart disease, and 10-year risk for atherosclerotic cardiovascular diseases （ASCVD） among 8,252 participants aged 〉 40 years without diabetes from Jiading district, Shanghai, China.Results Body mass index, waist circumference, blood glucose, glycated hemoglobin, blood pressure, and serum lipids increased progressively across the sex-specific quartiles of uric acid （all P trend 〈 0.05）. Compared with individuals in the lowest quartile, those in the higher quartiles had a significantly higher prevalence of obesity, hypertension, and dyslipidemia （all P trend 〈 0.05）. A fully adjusted logistic regression analysis revealed that individuals in the highest quartile had an increased risk of predicted cardiovascular disease compared with those in the lowest quartile of uric acid. The multivariate adjusted odds ratios （ORs） [95% confidence intervals （C/s）] for the highest quartiles for high Framingham risk were 3.00 （2.00-4.50） in men and 2.95 （1.08-8.43） in women. The multivariate adjusted ORs （95% C/s） for the highest quartile for high ASCVD risk were 1.93 [1.17-3.17） in men and 4.53 （2.57-7.98） in women.Conclusion Serum uric acid level is associated with an increased risk of prevalent obesity, hypertension, dystipidemia, 10-year Framingham risk for coronary heart disease, and lO-year risk for ASCVD among Chinese adults without diabetes.

Association between Serum Uric Acid to HDL-Cholesterol Ratio and Nonalcoholic Fatty Liver Disease Risk among Chinese Adults

Objective The aim of this case-control study was to explore the association between serum uric acid to high density lipoprotein cholesterol ratio(UHR) and the risk of nonalcoholic fatty liver disease(NAFLD) in Chinese adults.Methods A total of 636 patients with NAFLD and 754 controls were enrolled from the Affiliated Hospital of Qingdao University, China, between January and December 2016. All patients completed a comprehensive questionnaire survey and underwent abdominal ultrasound examination and a blood test. NAFLD was diagnosed using ultrasonography after other etiologies were excluded. Logistic regression and restricted cubic spline model were conducted to evaluate the relationship of UHR with NAFLD risk.Results The multivariable adjusted odds ratio(95% confidence interval, CI) for NAFLD in the highest versus lowest quartile of UHR was 3.888(2.324–6.504). In analyses stratified by sex and age, we observed significant and positive associations between UHR and the risk of NAFLD in each subgroup. In analyses stratified by body mass index(BMI), a significant and positive association was found only in individuals with a BMI of ≥ 24 kg/m2. Our dose-response analysis indicated a linear positive correlation between UHR and the risk of NAFLD.Conclusion UHR is positively associated with the risk of NAFLD and may serve as an innovative and noninvasive marker for identifying individuals at risk of NAFLD.

Predictive value of serum uric acid on cardiovascular disease and all-cause mortality in urban Chinese patients

Background The association between increased serum uric acid （SUA） levels and cardiovascular risk has been debated for decades. Several large studies have provided conflicting results regarding the clinical significance of elevated SUA levels in cardiovascular disease （CVD） or cerebrovascular disease. The aim of this study was to investigate the relationship between SUA and CVD and all-cause mortality and their potential diagnostic value. Methods A total of 3570 in-patients ranging in age from 56 to 95 years （mean （67.36_＋11.36） years） were selected from 20 hospitals in Beijing and Shanghai. A carefully designed questionnaire was used to gather baseline data of each patient All patients were divided into two main groups according to their SUA levels： high SUA and normal SUA groups. Serum indices and other important parameters were measured. Results Compared with normal SUA group, high SUA group had significant difference in systolic blood pressure （SBP）, total cholesterol （TC）, triglyceride （TG）, high density lipoprotein cholesterol （HDL-C）, body mass index （BMI）, and age （P 〈0.05 or P 〈0.01）. High SUA prevailed in female and patients with history of essential hypertension, while history of smoking and diabetes showed no significant difference between two groups. All-cause and CVD mortality occurred more frequently in high SUA group than in normal SUA group. In the accumulative survival analysis, high SUA group had lower survival rate than normal SUA group both in CVD and all-cause mortality. COX regression analysis indicated that the history of smoking, age and high SUA were independent risk factors for the development of CVD. Conclusions These preliminary observations suggest that patients with high SUA levels would face higher risk of mortality. SUA measurement may be applied as a routine predictor for clinical assessment.

Serum uric acid as a prognostic marker in the setting of advanced vascular disease： a prospective study in the elderly

Background Many epidemiological studies analyze the relationship between hyperuricemia and cardiovascular outcomes. This observational prospective study investigates the association of serum uric acid （SUA） levels with adverse cardiovascular events and deaths in an elderly population affected by advanced atherosclerosis. Methods Two hundred and seventy six elderly patients affected by advanced atherosclerosis （217 males and 59 females; aged 71.2 ±7.8 years） were included. All patients were assessed for history of cardiovascular disease, cancer, obesity and traditional risk factors. Patients were followed for approximately 31 ±11 months. Major events were recorded during follow-up, defined as myocardial infarction, cerebral isehemia, myocardial and/or peripheral revascularization and death. Results Mean SUA level was 5.47 ±1.43 mg/dL; then we further divided the population in two groups, according to the median value （5.36 mg/dL）. During a median follow up of 31 months （5 to 49 months）, 66 cardiovascular events, 9 fatal cardiovascular events and 14 cancer-related deaths have occurred. The patients with increased SUA level presented a higher significant incidence of total cardiovascular events （HR： 1.867, P = 0.014, 95% CI： 1.134-3.074）, The same patients showed a significant increased risk of cancer-related death （HR： 4.335, P = 0.025, 95% CI： 1.204-15.606）. Conclusions Increased SUA levels are independently and significantly associated with risk of cardiovascular events and cancer related death in a population of mainly elderly patients affected by peripheral vasculopathy.

Serum uric acid in patients with acute ST-elevation myocardial infarction

BACKGROUND:Few studies investigated serum uric acid levels in patients with acute STelevation myocardial infarction(STEMI).The study was to assess the clinical value of serum uric acid levels in patients with acute ST-elevation myocardial infarction(STEMI).METHODS:Totally 502 consecutive patients with STEMI were retrospectively studied from January 2005 to December 2010.The level of serum lipid,echocardiographic data and in-hospital major adverse cardiovascular events(MACE) in patients with hyperuricemia(n=119) were compared with those in patients without hyperuricemia(n=383).The relationship between the level of serum uric acid and the degree of diseased coronary artery was analyzed.All data were analyzed with SPSS version 17.0 software for Student's t test,the Chi-square test and Pearson's correlation coefficient analysis.RESULTS:Serum uric acid level was positively correlated with serum triglyceride level.Hyperlipidemia was more common in hyperuricemia patients than in non-hyperuricemia patients(43.7%vs.33.7%,P=0.047),and serum triglyceride level was significantly higher in hyperuricemia patients(2.11±1.24 vs.1.78±1.38,P=0.014).But no significant association was observed between serum uric acid level and one or more diseased vessels(P>0.05).Left ventricular end-diastolic diameter(LVEDd) was larger in hyperuricemia patients than in non-hyperuricemia patients(53.52±6.19 vs.52.18±4.89,P=0.041).The higher rate of left systolic dysfunction and diastolic dysfunction was discovered in hyperuricemia patients(36.4%vs.15.1%,P<0.001;68.2%vs.55.8%,P=0.023).Also,hyperuricemia patients were more likely to have in-hospital MACE(P<0.05).CONCLUSIONS:Serum uric acid level is positively correlated with serum triglyceride level,but not with the severity of coronary artery disease.Hyperuricemia patients with STEMI tend to have a higher rate of left systolic dysfunction and diastolic dysfunction and more likely to have more in-hospital MACE.

Serum cystatin C,monocyte/high-density lipoprotein-C ratio,and uric acid for the diagnosis of coronary heart disease and heart failure

BACKGROUND Coronary heart disease(CHD)and heart failure(HF)are the major causes of morbidity and mortality worldwide.Early and accurate diagnoses of CHD and HF are essential for optimal management and prognosis.However,conventional diagnostic methods such as electrocardiography,echocardiography,and cardiac biomarkers have certain limitations,such as low sensitivity,specificity,availability,and cost-effectiveness.Therefore,there is a need for simple,noninvasive,and reliable biomarkers to diagnose CHD and HF.AIM To investigate serum cystatin C(Cys-C),monocyte/high-density lipoprotein cholesterol ratio(MHR),and uric acid(UA)diagnostic values for CHD and HF.METHODS We enrolled 80 patients with suspected CHD or HF who were admitted to our hospital between July 2022 and July 2023.The patients were divided into CHD(n=20),HF(n=20),CHD+HF(n=20),and control groups(n=20).The serum levels of Cys-C,MHR,and UA were measured using immunonephelometry and an enzymatic method,respectively,and the diagnostic values for CHD and HF were evaluated using receiver operating characteristic(ROC)curve analysis.RESULTS Serum levels of Cys-C,MHR,and UA were significantly higher in the CHD,HF,and CHD+HF groups than those in the control group.The serum levels of Cys-C,MHR,and UA were significantly higher in the CHD+HF group than those in the CHD or HF group.The ROC curve analysis showed that serum Cys-C,MHR,and UA had good diagnostic performance for CHD and HF,with areas under the curve ranging from 0.78 to 0.93.The optimal cutoff values of serum Cys-C,MHR,and UA for diagnosing CHD,HF,and CHD+HF were 1.2 mg/L,0.9×10^(9),and 389μmol/L;1.4 mg/L,1.0×10^(9),and 449μmol/L;and 1.6 mg/L,1.1×10^(9),and 508μmol/L,respectively.CONCLUSION Serum Cys-C,MHR,and UA are useful biomarkers for diagnosing CHD and HF,and CHD+HF.These can provide information for decision-making and risk stratification in patients with CHD and HF.

Analysis of Blood Lipids, Blood Glucose, Blood Uric Acid, and Blood Routine Test Results in Retired Employees of a Unit in the Civil Aviation System

Objective:To investigate and analyze the annual physical examination results of retired employees from a unit in the civil aviation system,focusing on blood lipids,blood glucose,blood uric acid,and blood routine results.The study aims to provide relevant references for formulating reasonable disease management measures for preventing and controlling hyperlipidemia,hyperuricemia,and other conditions in retired employees.Methods:The examination results of 231 participants were collected and analyzed.The participants were divided into four groups based on age:middle-aged group,young-old group,middle-old group,and old-old group.The blood test results were compared across these groups,and an assessment of atherosclerotic cardiovascular disease(ASCVD)risk levels was completed in conjunction with medical history.Blood test results were also compared by gender.Results:There were no significant statistical differences in blood test results when grouped by age.However,the prevalence of hyperuricemia was higher in males than in females,while the prevalence of hypercholesterolemia was higher in females than in males.The LDL-C target achievement rate was lower in the moderate-and-high-risk group as well as the very high-risk group as defined by ASCVD risk levels.Conclusion:Management of hyperuricemia and hyperlipidemia in retired employees(elderly patients)should be strengthened to reduce the risk of ASCVD events and alleviate the potential medical burden associated with disease progression.

Relation of serum uric acid and cardiovascular plaque composition by intravascular ultrasound

Background To investigate the relationship btween serum uric acid （SUA） and cardiovascular plaque composition by intravascular ultrasound （IVUS）. Methods From March 2005 to August 2009, 81 patients were explored cardiovascular plaque composition by IVUS and taken SUA of measurement. According to American Heart Association IVUS criterion, coronary artery plaque was divided into four categories： （1） Fibrous plaque; （2） Soft plaque; （3） Calcified plaque; （4） Mixed plaque. We investigated the relationship btween SUA and cardiovascular plaque composition by IVUS. Results It was shown that the level of SUA in calcified plaque group was significantly higher than other three groups（P0.01）, which in fiber plaque group was significantly higher than mixed plaque group（P=0.032）, there was no significant difference between soft plaque group and mixed plaque group（P=1.00）among the four groups. The level of SUA among the four groups from high to low was as follows：calcified plaque, fibrous plaque group, soft plaque group and mixed plaque group. Conclusions The present study found that higher SUA in calcified plaque group, which proved that the relationship between SUA and cardiovascular plaque composition.

A prospective comparison cohort study between baseline serum uric acid level and coronary artery disease in first-degree relatives and non-first-degree relatives of type 2 diabetes males

Objective To investigate the relationship between baseline serum uric acid and the severity of coronary artery disease(CAD)in the first-degree relatives or nonfirst-degree relatives of men with type 2 diabetes.Methods Three hundred and eighty-one men with negative coronary angiography for the first time were divided into diabetes and non-diabetes groups and followed-up for

Association between serum uric acid level and the severity of coronaryartery disease in patients with obstructive coronary artery disease

Background Many studies have shown that the serum uric acid(SUA) level is one of the cardiovascular risk factors. The aim of the study is to evaluate the relationship between SUA levels and the severity of coronary artery disease(CAD) assessed by angiography and the Syntax score in patients with obstructive CAD.Methods Participants who visited our hospital for a coronary angiography, from December 2007 to September 2012, were eligible for this analysis. SUA and other blood parameters after at least 12-hour fast were determined. First, the patients were divided into tertiles according to their Syntax scores(low Syntax score group: Syntax score ≤10.0; moderate Syntax score group: 10.0 <Syntax score ≤18.0; high Syntax score group: Syntax score >18.0). Second, to clarify the association between SUA levels and major adverse cardiovascular events(MACEs), all patients were divided into two subgroups on the basis of SUA levels. The cutoff value of SUA was defined by diagnostic criteria of hyperuricemia. Patients were separated into normal SUA group(n=251, with SUA <416 μmol/L for men and SUA <357 μmol/L for women) and high SUA group(n=96, with SUA ≥416 μmol/L for men and SUA ≥357 μmol/L for women). All participants were followed for a mean of 22.0 months(1–75 months, interquartile range: 28 months) for major adverse cardiovascular events(MACEs), including all-cause death, recurrent nonfatal myocardial infarction(re-MI) and recurrent percutaneous coronary intervention(re-PCI). Results A total of 347 patients were registered for the study. The SUA levels in the high Syntax score group were significantly higher than that of the moderate Syntax score group and the low Syntax score group((392.3±81.6) μmol/L vs.(329.9±71.0) μmol/L, P <0.001;(392.3±81.6) μmol/L vs.(311.4±64.7) μmol/L, P <0.001). The SUA level was positively correlated not only with the Syntax score(r=0.421, P <0.001; 95% CI: 0.333–0.512), but also with the number of diseased vessels(r=0.298, P <0.001; 95% CI: 0.194–0.396). After multiple linear regression analysis, SUA levels were identified to be independently correlated with a high Syntax score(B=0.033, 95% CI 0.023–0.042, P <0.001). Compared with the normal SUA subgroup, the high SUA subgroup tended to have a higher Syntax score(19.9±8.7 vs. 13.6±7.5, P <0.001) and more multi-vessel disease(70.8% vs. 46.6%, P <0.001). Follow-up data showed a higher incidence of MACE in the high SUA subgroup(20.8% vs. 6.0%, P <0.001). Binary Logistic regression analysis indicated that the elevated SUA can predict the long-term prognosis of patients with obstructive CAD(OR=2.968, 95% CI 1.256–7.011, P=0.013). KaplanMeier analysis showed a significantly lower event-free survival rate in patients with high SUA levels than in the normal SUA subgroup(79.2% vs. 94.0%, Log rank=17.645, P <0.001). Conclusions SUA levels were independently associated with the severity of CAD in patients with obstructive CAD. An elevated SUA is associated with cardiovascular events and may be useful as a biomarker of the severity of CAD.

Association between serum uric acid level and mortality in China

Background:Whether there is an association between serum uric acid(SUA)level and risk of mortality in the general population remains unclear.Based on the China National Survey of Chronic Kidney Disease linked to mortality data,a population-based cohort study was performed to investigate the association between SUA level and all-cause mortality,cardiovascular disease(CVD)mortality,and cancer mortality in China.Methods:The survival status of participants in the cross-sectional survey was identified from January 1,2006 to December 31,2017.Only 33,268 individuals with complete SUA data among the 47,204 participants were included in the analysis.We determined the rates of all-cause mortality,CVD mortality,and cancer mortality.We used Cox proportional hazards regression models to evaluate the effect of the SUA level on mortality.Results:During a total of 297,538.4 person-years of follow-up,1282 deaths occurred.In the Cox proportional hazards regression model,the rate of all-cause mortality,CVD mortality,and cancer mortality had a U-shaped association with SUA levels only in men,whereas no significant associations were detected in women.For all-cause mortality in men,the multivariable-adjusted hazard ratios(HRs)in the first,second,and fourth quartiles compared with the third quartile were 1.31(95%confidence interval[CI]1.04–1.67),1.17(95%CI 0.92–1.47),and 1.55(95%CI 1.24–1.93),respectively.For CVD mortality,the corresponding HRs were 1.47(95%CI 1.00–2.18),1.17(95%CI 0.79–1.75),and 1.67(95%CI 1.16–2.43),respectively.For the cancer mortality rate,only a marginally significant association was detected in the fourth quartile compared with the third quartile with an HR of 1.43(95%CI 0.99–2.08).Conclusions:The association between SUA and mortality differed by sex.We demonstrated a U-shaped association with SUA levels for all-cause and CVD mortalities among men in China.

Association between serum uric acid and different states of glucose metabolism and glomerular filtration rate

Background Recently, it has been suggested that the serum uric acid （SUA） level decreased in diabetic patients. The aim of this study was to explore the association between SUA level and different state of glucose metabolism and glomerular filtration rate （GFR） reflected by the simplified Modification of Diet in Renal Disease （MDRD） equation and to test the hypothesis that high MDRD is one of the determinants of SUA level.Methods This cross-sectional study included 2373 subjects in Beijing who underwent a 75 g oral glucose tolerance test （OGTT） for screening of diabetes. According to the states of glucose metabolism, they were divided into normal glucose tolerance, impaired glucose regulation and diabetes.Results Multiple stepwise linear regression analysis showed that adjusted by gender, SUA was positively correlated with body mass index （BMI）, waist/hippo ratio, systolic blood pressure （SBP） and triglyceride, meanwhile negatively correlated with age, hemoglobin A1c, fasting insulin and MDRD. There was an increasing trend in SUA concentration and a decreasing trend in MDRD when the levels of fasting plasma glucose （FPG） increased from low to high up to the FPG level of 8.0 mmol/L; thereafter, the SUA concentration started to decrease with further increases in FPG levels, and the MDRD started to increase with further increases in FPG levels.Conclusion This study confirmed the previous finding that SUA decreased in diabetes and provided the supporting evidence that the increased MDRD might contribute to the fall of SUA.

Research survey and review of the effect of Compound Danshen Dripping Pills on the uric acid metabolism of patients with coronary heart disease

A growing number of studies have reported that serum uric acid（SUA） is associated with coronary heart disease（CHD）, which has been increasingly recognized and valued by the medical community. This paper surveys the epidemiological studies of hyperuricemia and CHD and summarizes the clinical study discussing the association between hyperuricemia and coronary heart disease with a prospect of exploring the possible mechanisms of compound Danshen dripping pills in reducing SUA in patients with coronary heart disease.

缺血性脑血管病血清尿酸水平与颈动脉不稳定斑块关系

目的 探讨缺血性脑血管病血清尿酸水平与颈动脉不稳定斑块关系。方法 选择60例缺血性脑血管病患者,其中,短暂性脑缺血发作30例(短暂性脑缺血发作组);脑梗死30例(脑梗死组),测定两组患者的血清尿酸水平,分析缺血性脑血管病血清尿酸水平与颈动脉不稳定斑块的关系。结果 短暂性脑缺血发作组的血清尿酸水平显著低于脑梗死组(P<0.05)。Logtisic回归分析显示,血清尿酸水平升高是缺血性脑血管病患者斑块发生的危险因素(P<0.05)。随着斑块面积增大,血清尿酸水平升高(P<0.05)。结论 缺血性脑血管病血清尿酸水平与颈动脉不稳定斑块关系密切,血清尿酸水平是患者斑块发生的独立危险因素,通过早期监测血清尿酸水平,可更好地评估颈动脉斑块的不稳定性,为疾病早期诊治提供基础。

血清血尿酸及甲状腺激素与2型糖尿病患者发生动脉粥样硬化性心血管疾病的关系

目的探究血清血尿酸(SUA)及甲状腺激素水平与2型糖尿病(T2DM)患者发生动脉粥样硬化性心血管疾病(ASCVD)的关系,并构建发生风险预测模型。方法回顾性选取2020年5月至2023年5月丽水市人民医院内分泌科诊治的326例T2DM患者,根据是否发生ASCVD,将其分为发生组(n=152)与未发生组(n=174)。收集所有研究对象临床资料以血清SUA及甲状腺激素(TT3、TT4、FT3、FT4、TSH)水平。采用单因素logistic回归、多因素logistic回归分析T2DM患者发生ASCVD的危险因素,依据危险因素构建T2DM患者发生ASCVD的风险列线图预测模型。结果两组对象年龄、空腹血糖、糖尿病病程、三酰甘油、SUA、TSH水平比较,差异有统计学意义(P<0.05),除此外,两组其他资料比较差异无统计学意义(P>0.05)。二元logistics回归结果显示,年龄大、糖尿病病程长、三酰甘油高、SUA水平高、TSH水平高为T2DM患者发生ASCVD的独立危险因素(P<0.05)。受试者工作特征(ROC)曲线分析结果显示,年龄、糖尿病病程、三酰甘油、SUA、TSH及列线图预测模型的ROC曲线下面积(AUC)分别为0.711、0.702、0.668、0.755、0.965、0.987,可知,均对T2DM患者发生ASCVD有较好的预测价值。当取cut-off时,各自敏感度分别为0.638、0.539、0.638、0.730、0.941、0.960,特异度分别为0.690、0.799、0.644、0.661、0.943、0.954。Bootstrap法(B=1000)对列线图预测模型进行内部验证显示,Bias-corrected预测曲线与Ideal线基本重合,C-index为0.975,该模型预测能力较好。决策曲线显示,该模型的阈值概率范围为0.01~0.98,其净收益率>0。结论血清SUA及甲状腺激素水平是预测T2DM患者发生ASCVD的重要指标,构建的风险列线图预测模型具有较好的预测性能和临床应用价值。

血尿酸、酸碱平衡紊乱及其交互作用在慢阻肺免疫功能下降中的作用研究

目的探讨血尿酸(Serum Uric Acid,SUA)、酸碱平衡紊乱及其交互作用对慢性阻塞性肺疾病(Chronic Obstructive Pulmonary Disease,COPD)患者免疫功能下降的影响。方法选取2022年10月—2023年10月钦州市第二人民医院收治的223例COPD患者为研究对象。根据患者是否出现免疫功能下降分为免疫功能下降组(n=67)和免疫功能正常组(n=156)。比较两组的SUA水平、血氧分压(Partial Pressure of Oxygen,PO_(2))、二氧化碳分压(Partial Pressure of Carbon Dioxide,PCO_(2))、碳酸氢根离子和碱剩余(Base Excess,BE),分析SUA和酸碱平衡指标之间的交互作用。结果两组PO_(2)、PCO_(2)、碳酸氢根离子和SUA水平比较,差异有统计学意义(P均<0.05)。PO_(2)、PCO_(2)、碳酸氢根离子、SUA均为COPD患者免疫功能下降的影响因素(OR=2.484、2.554、2.891、5.757,P均<0.05);碳酸氢根离子与SUA存在相加交互作用,但未发现存在相乘交互作用;PO_(2)、PCO_(2)与SUA均不存在相加、相乘交互作用。结论SUA、PO_(2)、PCO_(2)和碳酸氢根离子是COPD患者免疫功能下降的影响因素,并且SUA和HCO3存在相加交互作用,各因素之间无相乘交互作用。

不同心力衰竭亚型老年患者血清尿酸与预后的关系

背景血清尿酸(serum uric acid,sUA)与炎症和微血管功能障碍有关,对不同的心力衰竭分型可能有不同的影响。目的研究sUA水平与不同左心室射血分数心力衰竭亚型老年患者预后的关系。方法纳入2014年9月—2017年7月解放军总医院第一医学中心和苏州大学附属第一医院心血管内科住院的老年慢性心力衰竭患者,所有患者入院24 h内接受血清尿酸的检测。随访至2017年9月,以心血管死亡事件为终点事件,以多因素Cox回归模型评估sUA水平对预后的影响。结果1355例患者中位随访时间18个月,总体上心血管死亡事件发生率为6.8%(92例),射血分数减低的心力衰竭(heart failure with reduced ejection fraction,HFrEF)、射血分数中间值的心力衰竭(heart failure with mid-range ejection fraction,HFmrEF)和射血分数保留的心力衰竭(heart failure with preserved ejection fraction,HFpEF)三组心血管死亡事件发生率分别为13.9%(47例)、6.1%(24例)和3.4%(21例)。与低sUA组相比,高sUA组患者心血管死亡事件的发生风险更高(HR=2.141,95%CI:1.199~3.824,P=0.01)。亚组分析中,在HFrEF患者中,与低sUA组相比,高sUA组不良事件发生风险也升高(HR=4.151,95%CI:1.866~9.234,P<0.001);在HFmrEF患者中,高sUA组心血管死亡事件发生风险相较低sUA组同样升高(HR=4.724,95%CI:1.664~13.414,P=0.004)。结论sUA水平的升高与老年HFrEF和HFmrEF患者心血管不良预后相关。

从虚-湿-热-瘀探讨NLR、标化SUA与早期糖尿病肾病的相关性

【目的】基于“虚-湿-热-瘀”病机探讨外周血中性粒细胞计数与淋巴细胞计数比值(NLR)、标化SUA[血尿酸与血肌酐比值(SUA/Scr)]与早期糖尿病肾病(early diabetic kidney disease,EDKD)中医证型的相关性,为EDKD患者中医精准化治疗提供客观化依据。【方法】回顾性分析197例EDKD患者(包括单纯气阴两虚证42例、气阴两虚兼湿证44例、气阴两虚兼热证53例、气阴两虚兼瘀证58例)的临床资料,对比不同中医证型EDKD患者脂代谢指标、肾功能指标、NLR、标化SUA的水平差异,探讨NLR、标化SUA与EDKD中医证型的相关性。【结果】(1)不同中医证型EDKD患者的性别、糖化血红蛋白(HbA1c)比较,差异均无统计学意义(P>0.05);年龄方面,气阴两虚兼瘀证组年龄大于气阴两虚证组(P<0.05);病程方面,气阴两虚兼瘀证组病程大于其余各组(P<0.01);体质量指数(BMI)方面,气阴两虚证组<气阴两虚兼瘀证组<气阴两虚兼热证组<气阴两虚兼湿证组(P<0.05)。(2)气阴两虚证组的总胆固醇(TC)水平低于气阴两虚兼湿证组和气阴两虚兼瘀证组(P<0.05),气阴两虚证组的甘油三酯(TG)水平低于气阴两虚兼瘀证组(P<0.05),气阴两虚兼热证组的血肌酐(Scr)水平高于气阴两虚证组和气阴两虚兼湿证组(P<0.05),气阴两虚证组的肾小球滤过率(eGFR)水平高于气阴两虚兼热证组和气阴两虚兼瘀证组(P<0.05),气阴两虚兼热证组的NLR水平高于其余3组(P<0.05),气阴两虚兼瘀证组的标化SUA水平低于气阴两虚兼湿证组和气阴两虚兼热证组(P<0.05)。(3)无序多分类Logistic回归分析结果显示,BMI、SUA是气阴两虚兼湿证的影响因素,BMI、SUA、NLR是气阴两虚兼热证的影响因素,BMI、TC、标化SUA是气阴两虚兼瘀证的影响因素,差异均有统计学意义(P<0.05或P<0.01)。【结论】NLR和标化SUA可作为EDKD中医证型的参考指标,NLR水平升高可能会加速气阴两虚兼热证的发生,标化SUA水平降低可能会加速气阴两虚兼瘀证的发生。

非酒精性脂肪性肝病患者血尿酸水平与心房颤动的相关性研究

目的探讨非酒精性脂肪性肝病(NAFLD)患者血尿酸水平与心房颤动的相关性。方法回顾性选取2020年1月至2022年12月于山西医科大学第二医院诊断为NAFLD的患者565例,根据是否合并心房颤动将其分为心房颤动组(224例)和非心房颤动组(341例)。分析2组患者的临床资料。多因素Logistic回归分析用于确定NAFLD患者心房颤动发生的相关因素。使用趋势性检验分析血尿酸水平与心房颤动之间的线性趋势。构建列线图模型预测心房颤动的发生风险,绘制校准曲线来评价列线图的准确性。最后绘制受试者工作特征(ROC)曲线,评估血尿酸和列线图模型对NAFLD患者心房颤动发生的预测价值。结果多因素Logistic回归结果显示,年龄(比值比=1.096,95%置信区间:1.071~1.121,P<0.001)、血肌酐(比值比=1.021,95%置信区间:1.003~1.039,P=0.025)及血尿酸(比值比=1.008,95%置信区间:1.005~1.011,P<0.001)是NAFLD患者心房颤动发生的独立危险因素,高密度脂蛋白(P=0.010)是独立保护因素。心房颤动的风险随着血尿酸水平的升高而增加(趋势性检验P<0.001)。列线图模型预测心房颤动的C指数为0.827(95%置信区间:0.793~0.861),Hosmer-Lemeshow检验和校准图均显示该模型的校准度良好。ROC分析显示列线图模型的曲线下面积为0.827,优于血尿酸的0.683。结论血尿酸水平升高是NAFLD患者心房颤动发生的独立危险因素。

帕金森病患者血尿酸及同型半胱氨酸水平与认知障碍的相关性研究

目的本研究的目的是探讨血尿酸(uric acid,UA)、同型半胱氨酸(homocysteine,HCY)水平与帕金森病(parkinson’s disease,PD)患者的病情分期、认知功能改变的相关性。方法选择我院2015—2018年收治的PD患者和健康体检者各60例为研究对象,对肌酐、UA、HCY水平进行检测,使用Hoehn-Yahr(H-Y)分期,将PD组患者分为早期组(1~2.5期)、中晚期组(3~5期)两个亚组,使用蒙特利尔认知评估量表将帕金森病患者分成认知功能障碍组及认知功能正常组两个亚组。比较分析帕金森病患者与正常对照组及PD各亚组之间的尿酸、同型半胱氨酸水平有无差异。结果(1)PD组的UA水平明显低于对照组。(2)PD组的HCY水平明显高于对照组。(3)PD中晚期组的UA水平低于早期组,PD中晚期组的HCY水平明显高于PD早期组。(4)PD认知障碍组的UA水平低于认知功能正常组。(5)PD认知功能障碍组的HCY水平高于PD认知功能正常组。结论检测UA、HCY水平可能在发现早期PD及其早期认知功能障碍方面有重要价值;在一定范围内提高UA水平同时降低HCY水平可能为控制或延缓PD快速进展、改善PD认知功能等提供潜在的治疗意义。