Ruggiero Carmelinda, Cherubini Antonio, Miller Edgar, Maggio Marcello, Najjar Samer S, Lauretani Fulvio, Bandinelli Stefania, Senin Umberto, Ferrucci Luigi
Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA.
Am J Cardiol. 2007 Jul 1;100(1):115-21. doi: 10.1016/j.amjcard.2007.02.065. Epub 2007 May 24.
The role of uric acid (UA) in the process of atherothrombosis is controversial. Although serum UA has powerful antioxidant properties, epidemiological studies showed that UA was a risk factor for cardiovascular diseases and was positively associated with proinflammatory markers. Relations between baseline UA and changes in UA circulating levels with C-reactive protein (CRP) and interleukin-6 (IL-6) after 3 years of follow-up in a cohort of 892 Italian men and women aged 21 to 98 years was investigated. Subjects had complete baseline and follow-up data for UA, inflammatory markers, and covariates. An autoregressive approach was used to study such a relation. In adjusted analyses, baseline UA and changes in UA predicted a 3-year change in CRP (p = 0.028), but not IL-6 (p = 0.101). The relation between UA and CRP persisted after adjustment for baseline IL-6. Subjects with high UA at baseline had a progressively higher probability of developing clinically relevant increased IL-6 (>2.5 pg/ml) and CRP (>3 mg/L) during 3 years. In conclusion, our study suggests that in a population-based cohort, baseline UA and changes in circulating UA during 3 years of follow-up predict changes in circulating CRP independent of relevant confounders, including baseline IL-6.
尿酸(UA)在动脉粥样硬化血栓形成过程中的作用存在争议。尽管血清尿酸具有强大的抗氧化特性,但流行病学研究表明,尿酸是心血管疾病的一个危险因素,并且与促炎标志物呈正相关。在一个由892名年龄在21至98岁的意大利男性和女性组成的队列中,研究了基线尿酸水平以及随访3年后尿酸循环水平的变化与C反应蛋白(CRP)和白细胞介素-6(IL-6)之间的关系。受试者拥有关于尿酸、炎症标志物和协变量的完整基线和随访数据。采用自回归方法来研究这种关系。在调整分析中,基线尿酸水平和尿酸变化可预测CRP的3年变化(p = 0.028),但不能预测IL-6的变化(p = 0.101)。在对基线IL-6进行调整后,尿酸与CRP之间的关系依然存在。基线尿酸水平高的受试者在3年内发生临床上相关的IL-6升高(>2.5 pg/ml)和CRP升高(>3 mg/L)的可能性逐渐增加。总之,我们的研究表明,在一个基于人群的队列中,基线尿酸水平以及随访3年期间尿酸循环水平的变化可独立于包括基线IL-6在内的相关混杂因素预测循环CRP的变化。