[The association between uric acid and coronary heart disease].

OBJECTIVE

To determine the association between uric acid and coronary artery disease (CAD) and whether the relationship is gender dependent.

METHOD

A cross-sectional study of 355 men and women with or without CAD was performed. Coronary artery angiography was done for all the subjects. Patients treated with diuretics, isopurinol, aspirin, lipid-lowering agents and heparin and patients with renal, hepatic, or thyroid diseases were excluded. Gender, age, body mass index, fasting plasma glucose, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, fibrinogen, cigarette smoking consumption, CAD family history, essential hypertension history and CAD severity were analyzed. Cigarette smoking consumption was graded as follows: 0: no smoking, 1: </= 5 pack-year, 2: 5 to 10 pack-year, 3: greater than 10 pack-year. CAD severity was scored angiographically as follows: 0 (absent): no evidence of CAD; 1 (mild): 1-vessel disease with < 50% stenosis; 2 (moderate): 1-vessel disease with >/= 50% stenosis, or 2-vessel disease, both vessels with < 50% stenosis or 1 with < 50% and the other with > 50% stenosis, or 3-vessel disease, all with < 50% stenosis; 3 (severe): 2-vessel disease, both with > 50% stenosis, or 3-vessel disease with >/= stenosis in one vessel > 50%.

RESULTS

The upper uric acid qunrtiles in the women group were associated with higher CAD severity than the lower uric acid qunrtiles. The mean CAD severity score according to the uric acid qunrtiles were 2.10 (uric acid 163 approximately 217.5 micro mol/L) 2.27, (uric acid 218.0 approximately 276.0 micro mol/L) 2.36 (uric acid 277.0 approximately 335.0 micro mol/L) and 2.62 (uric acid 336.0 approximately 694.0 micro mol/L). No such relation was found in men. With multiple logistic regression, gender (B = 0.924, P = 0.012, OR = 2.520), fasting plasma glucose (B = 0.391, P = 0.006, OR = 1.478), fibrinogen (B = 0.007, P = 0.000, OR = 1.007) and cigarette smoking consumption grading (B = 0.306, P = 0.018, OR = 1.358) were independently associated with CAD, there was a trend association between age and CAD (B = 0.032, P = 0.056, OR = 1.032), Uric acid (B = 0.002, P = 0.349, OR = 0.998) and other variables did not have significant independent association with CAD. With stepwise multiple regression analysis, fibrinogen, fasting plasma glucose, total cholesterol, gender, age showed significant independent association with CAD severity, but uric acid (B = 0.004, beta = 0.025, t = 0.373, P = 0.709) and other variables did not. In the female group, CAD or CAD severity was independently associated with triglyceride and fibrinogen, but not with uric acid.

CONCLUSIONS

The upper uric acid qunrtiles in the women group have higher CAD severity than the lower uric acid qunrtiles. However, with multiple regression, either in women or in men, uric acid was not independently associated with CAD or CAD severity.