Høieggen Aud, Os Ingrid, Kjeldsen Sverre E
Nyremedisinsk avdeling, Medisinsk divisjon, Ullevål universitetsykehus, 0407 Oslo. aud.hoieggen@ ulleval.no
Tidsskr Nor Laegeforen. 2005 May 19;125(10):1330-2.
Hyperuricaemia is associated with reduced renal function and increased cardiovascular risk. It is still disputed, however, whether hyperuricaemia is an independent cardiovascular risk factor or just a marker of increased cardiovascular risk.
A review of the literature based on Medline is presented and data from the LIFE (Losartan Intervention For Endpoint reduction in hypertension) study discussed in relation to the association between uric acid and cardiovascular events.
Epidemiological data have shown an independent relationship between serum uric acid and cardiovascular risk, at least in women. In LIFE, uric acid at baseline corresponded positively with cardiovascular risk in women, though not in men. Differences in serum uric acid during the study could statistically explain 29% of the reduction in cardiovascular events in the losartan group compared to atenolol.
These findings support the hypothesis that uric acid is an independent cardiovascular risk factor. Further studies are warranted.
高尿酸血症与肾功能减退及心血管疾病风险增加相关。然而，高尿酸血症究竟是一个独立的心血管危险因素，还是仅仅是心血管疾病风险增加的一个标志物，目前仍存在争议。
本文基于医学在线数据库（Medline）对相关文献进行了综述，并讨论了氯沙坦干预降低高血压终点事件（LIFE）研究中尿酸与心血管事件之间关联的数据。
流行病学数据表明，血清尿酸与心血管疾病风险之间存在独立关系，至少在女性中如此。在LIFE研究中，基线尿酸水平与女性心血管疾病风险呈正相关，而在男性中则不然。研究期间血清尿酸的差异在统计学上可以解释氯沙坦组相较于阿替洛尔组心血管事件减少29%的原因。
这些发现支持了尿酸是一个独立的心血管危险因素这一假说。有必要进行进一步研究。
