Baker Joshua F, Krishnan Eswar, Chen Lan, Schumacher H Ralph
University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
Am J Med. 2005 Aug;118(8):816-26. doi: 10.1016/j.amjmed.2005.03.043.
The relationship between serum uric acid (SUA) and cardiovascular disease has been controversial. Here we review recent literature assessing whether hyperuricemia is an independent risk factor for adverse cardiovascular outcomes. Studies from the past 6 years evaluating the association of SUA with cardiovascular disease were identified through MEDLINE, EMBASE, and Cochrane library searches, bibliography cross-referencing, and review articles. Twenty-one cohort studies in healthy and high-risk patients with cardiovascular disease were identified and reviewed. In studies of high-risk patients, in which more overall events were recorded, 10 of 11 studies were supportive of an independent association. In 10 studies of healthy patients, 6 suggested an independent association of SUA with adverse cardiovascular outcomes. Increasing SUA is likely an independent risk factor for cardiovascular disease in high-risk individuals. However, the magnitude of excess risk attributable to high SUA is likely to be small in healthy individuals. Trials of SUA-lowering therapy in hyperuricemic patients evaluating the effect on cardiovascular outcomes are justified in high-risk patients.
血清尿酸（SUA）与心血管疾病之间的关系一直存在争议。在此，我们回顾近期文献，评估高尿酸血症是否为不良心血管结局的独立危险因素。通过检索MEDLINE、EMBASE和Cochrane图书馆、参考文献交叉引用以及综述文章，确定了过去6年中评估SUA与心血管疾病关联的研究。共识别并综述了21项针对健康及心血管疾病高危患者的队列研究。在记录了更多总体事件的高危患者研究中，11项研究中有10项支持存在独立关联。在10项针对健康患者的研究中，6项表明SUA与不良心血管结局存在独立关联。SUA升高可能是高危个体发生心血管疾病的独立危险因素。然而，在健康个体中，高SUA所致额外风险的程度可能较小。在高尿酸血症患者中进行降低SUA治疗以评估其对心血管结局影响的试验，对于高危患者是合理的。
