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未经治疗的原发性高血压患者血清尿酸、代谢综合征与微量白蛋白尿之间的关联

Association between serum uric acid, metabolic syndrome and microalbuminuria in previously untreated essential hypertensive patients.

作者信息

Rodilla Enrique, Pérez-Lahiguera Francisco, Costa José A, González Carmen, Miralles Amparo, Moral Desamparados, Pascual José María

机构信息

Unidad de Hipertensión, Servicio de Medicina Interna, Hospital de Sagunto, Agencia Valenciana de Salud, Sagunto, Valencia, España.

出版信息

Med Clin (Barc). 2009 Jan 17;132(1):1-6. doi: 10.1016/j.medcli.2008.07.008. Epub 2008 Dec 3.

Abstract

BACKGROUND AND OBJECTIVE

The aim of the study was to assess the association of serum uric acid levels with microalbuminuria -urinary albumin excretion (UAE)> or = 30mg/24h-.

PATIENTS AND METHOD

Cross-sectional study in 429 (220 women) hypertensive, non diabetic, never treated patients (mean age: 47 years) with glomerular filtration rate > or =60ml/min/1.73m(2).

RESULTS

The prevalence of microalbuminuria was 20.5%; 18% had hyperuricemia and 47% fulfilled the criteria for metabolic syndrome (MS). Baseline UAE correlated in the unvaried analysis to diastolic blood pressure, waist circumference, high-density lipoprotein cholesterol and uric acid. In multiple linear regression models, only MS (beta=0.113; p=0.03), and serum uric acid values (beta=0.04; p=0.05) were independently associated with logUAE, after adjustment for age and sex. Hyperuricemia (serum uric acid level > or =7.0mg/dl for men and > or =6.5mg/dl for women; odds ratio=2.18; 95% confidence interval, 1.21-3.92; p=0.010), and MS (odds ratio=2.16; 95% confidence interval, 1.32-3.53; p=0.002) were independently associated with a higher risk of microalbuminuria in multiple logistic regression analyses. The prevalence of microalbuminuria was 45.8% in patients with coexistent MS and hyperuricemia, as compared to 13.6% in hypertensive patients without it (p<0.001). In patients with concomitant MS and hyperuricemia the probability of being microalbuminuric was 3.7 times higher than in patients without those factors.

CONCLUSION

Serum uric acid level is associated with microalbuminuria. Coexistence of MS and hyperuricemia in hypertensive patients increases almost 4 times the odds of being microalbuminuric.

摘要

背景与目的

本研究旨在评估血清尿酸水平与微量白蛋白尿(尿白蛋白排泄率[UAE]≥30mg/24小时)之间的关联。

患者与方法

对429例(220例女性)高血压、非糖尿病且未接受过治疗的患者(平均年龄:47岁)进行横断面研究,这些患者的肾小球滤过率≥60ml/min/1.73m²。

结果

微量白蛋白尿的患病率为20.5%;18%有高尿酸血症,47%符合代谢综合征(MS)标准。在单变量分析中,基线UAE与舒张压、腰围、高密度脂蛋白胆固醇和尿酸相关。在多元线性回归模型中,调整年龄和性别后,仅MS(β=0.113;p=0.03)和血清尿酸值(β=0.04;p=0.05)与logUAE独立相关。在多元逻辑回归分析中,高尿酸血症(男性血清尿酸水平≥7.0mg/dl,女性≥6.5mg/dl;优势比=2.18;95%置信区间,1.21 - 3.92;p=0.010)和MS(优势比=2.16;95%置信区间,1.32 - 3.53;p=0.002)与微量白蛋白尿的较高风险独立相关。合并MS和高尿酸血症的患者中微量白蛋白尿的患病率为45.8%,而无此情况的高血压患者中为13.6%(p<0.001)。在合并MS和高尿酸血症的患者中,微量白蛋白尿的概率比无这些因素的患者高3.7倍。

结论

血清尿酸水平与微量白蛋白尿相关。高血压患者中MS和高尿酸血症并存使微量白蛋白尿的几率增加近4倍。

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