患有和未患有外周动脉疾病的高血压患者的血清尿酸

Serum uric acid in hypertensive patients with and without peripheral arterial disease.

作者信息

Langlois Michel, De Bacquer Dirk, Duprez Daniel, De Buyzere Marc, Delanghe Joris, Blaton Victor

机构信息

Department of Clinical Chemistry, AZ St-Jan AV Hospital, Ruddershove 10, B-8000 Brugge, Belgium.

出版信息

Atherosclerosis. 2003 May;168(1):163-8. doi: 10.1016/s0021-9150(03)00093-5.

DOI:10.1016/s0021-9150(03)00093-5

PMID:12732400

Abstract

BACKGROUND

Uric acid is frequently elevated in hypertension. In addition to renal and metabolic disturbances, lower limb ischemia might contribute to hyperuricemia among hypertensives complicated by peripheral arterial disease (PAD).

OBJECTIVE

To test the hypothesis that uric acid status is related to lower limb function in hypertensives with PAD.

METHODS

Serum and 24-h urine uric acid levels and other risk factors were examined in 145 hypertensives free of PAD and 166 hypertensives with PAD. Ankle/brachial index (ABI) and absolute claudication distance (in PAD) on a treadmill test (ACD) were assessed.

RESULTS

In multiple regression analysis for serum uric acid in the total group, PAD emerged as an independent determinant (P=0.03) next to age (P=0.005), triglycerides (P=0.04), and insulin (P=0.02). Serum uric acid concentrations were higher in hypertensives with PAD (404+/-101 vs. 347+/-80 micromol/l, P<0.001) independent of components of the metabolic syndrome (body mass index, triglycerides, insulin) and of age, gender, diabetes mellitus, pulse pressure, cholesterol, C-reactive protein, and treatment. After adjustment for kidney function by uric acid/creatinine ratio, values remained higher in hypertensives with PAD (P=0.01). Uric acid excretion was higher in the PAD group (P<0.001), whereas uric acid clearance was comparable between both groups. In multiple regression analysis for ACD (357+/-183 m) in the PAD group, serum uric acid (P=0.02), C-reactive protein (P<0.0001), age (P=0.02), and smoking (P=0.004) were independently associated. ABI (0.62+/-0.17) was not related to uric acid in PAD patients.

CONCLUSION

Hyperuricemia is more pronounced in hypertensives complicated by PAD and is associated with worse functional status of the peripheral circulation.

摘要

背景

高血压患者尿酸水平常升高。除了肾脏和代谢紊乱外，下肢缺血可能是导致合并外周动脉疾病（PAD）的高血压患者出现高尿酸血症的原因之一。

目的

验证尿酸状态与合并PAD的高血压患者下肢功能相关这一假设。

方法

对145例无PAD的高血压患者和166例合并PAD的高血压患者进行血清及24小时尿尿酸水平检测，并检查其他危险因素。通过跑步机试验评估踝臂指数（ABI）和绝对跛行距离（在PAD患者中为ACD）。

结果

在对全组患者血清尿酸进行的多元回归分析中，除年龄（P = 0.005）、甘油三酯（P = 0.04）和胰岛素（P = 0.02）外，PAD成为独立决定因素（P = 0.03）。合并PAD的高血压患者血清尿酸浓度更高（404±101 vs. 347±80 μmol/l，P<0.001），且不受代谢综合征各组分（体重指数、甘油三酯、胰岛素）以及年龄、性别、糖尿病、脉压、胆固醇、C反应蛋白和治疗的影响。经尿酸/肌酐比值校正肾功能后，合并PAD的高血压患者的尿酸值仍更高（P = 0.01）。PAD组尿酸排泄更高（P<0.001），而两组间尿酸清除率相当。在对PAD组ACD（357±183 m）进行的多元回归分析中，血清尿酸（P = 0.02）、C反应蛋白（P<0.0001）、年龄（P = 0.02）和吸烟（P = 0.004）与之独立相关。PAD患者的ABI（0.62±0.17）与尿酸无关。