Bos Michiel J, Koudstaal Peter J, Hofman Albert, Witteman Jacqueline C M, Breteler Monique M B
Department of Epidemiology & Biostatistics, Erasmus Medical Center, Rotterdam, The Netherlands.
Stroke. 2006 Jun;37(6):1503-7. doi: 10.1161/01.STR.0000221716.55088.d4. Epub 2006 May 4.
The role of uric acid as a risk factor for myocardial infarction is controversial, and little is known about its role as a risk factor for stroke. Recent evidence suggests that uric acid may be an important causal agent in cardiovascular disease, for example, by inducing renal disease and hence hypertension. We investigated the association between serum uric acid and coronary heart disease and stroke in a large prospective population-based study.
The study was based on 4385 participants of the Rotterdam Study who, at baseline (1990 to 1993), were > or =55 years of age, free from stroke and coronary heart disease, and had blood taken. Follow-up for incident stroke and myocardial infarction was complete until January 1, 2002. Data were analyzed with Cox proportional hazards models with adjustment for relevant confounders.
Average follow-up was 8.4 years. High serum uric acid levels were associated with risk of myocardial infarction and stroke; age- and sex-adjusted hazard ratios (95% CIs) for highest versus lowest quintile of uric acid were 1.68 (1.24 to 2.27) for cardiovascular disease (515 cases), 1.87 (1.12 to 3.13) for myocardial infarction (194 cases), 1.57 (1.11 to 2.22) for stroke (381 cases), 1.77 (1.10 to 2.83) for ischemic stroke (205 cases), and 1.68 (0.68 to 4.15) for hemorrhagic stroke (46 cases). Adjustment for other vascular risk factors only slightly attenuated these associations. Associations were stronger in persons without hypertension than in those with hypertension.
Uric acid is a strong risk factor for myocardial infarction and stroke.
尿酸作为心肌梗死风险因素的作用存在争议，而其作为中风风险因素的作用则鲜为人知。最近的证据表明，尿酸可能是心血管疾病的重要致病因素，例如，通过引发肾脏疾病进而导致高血压。我们在一项基于大规模前瞻性人群的研究中，调查了血清尿酸与冠心病及中风之间的关联。
该研究基于鹿特丹研究的4385名参与者，这些参与者在基线期（1990年至1993年）年龄≥55岁，无中风和冠心病，且已采集血液样本。对中风和心肌梗死的发病情况随访至2002年1月1日结束。采用Cox比例风险模型对数据进行分析，并对相关混杂因素进行校正。
平均随访时间为8.4年。高血清尿酸水平与心肌梗死和中风风险相关；尿酸最高五分位数与最低五分位数相比，经年龄和性别校正后的风险比（95%可信区间），心血管疾病（515例）为1.68（1.24至2.27），心肌梗死（194例）为1.87（1.12至3.13），中风（381例）为1.57（1.11至2.22），缺血性中风（205例）为1.77（1.10至2.83），出血性中风（46例）为1.68（0.68至4.15）。对其他血管风险因素进行校正后，这些关联仅略有减弱。在无高血压者中，关联比有高血压者更强。
尿酸是心肌梗死和中风的强风险因素。
