Graduate Institute of Clinical Medical Sciences, Chang Gung University, Kwei-Shan Tao-Yuan, Taiwan.
Rheumatology (Oxford). 2010 Jan;49(1):141-6. doi: 10.1093/rheumatology/kep364. Epub 2009 Nov 20.
The relation of gout and hyperuricaemia to cardiovascular diseases has been well documented. This study investigates the survival impact of both gout and hyperuricaemia.
The subjects of this study comprised participants of a health screening programme conducted by the Chang Gung Memorial Hospital in Taiwan from 2000 to 2006. The status and causes of death were ascertained by the Taiwan National Death Registry 2000-07. Cox proportional hazard model was performed to examine the association.
Among 61 527 subjects, 1383 deaths (198 cardiovascular deaths) were identified, corresponding to a crude mortality rate of 4.86 deaths per 1000 person-years. Crude mortality rates were 4.50, 5.61 and 10.46 deaths per 1000 person-years for subjects with normouricaemia, hyperuricaemia and gout, respectively. Compared with subjects with normouricaemia, the hazard ratios (HRs) of all-cause mortality were 1.46 (95% CI 1.12, 1.91) for individuals with gout and 1.07 (95% CI 0.94, 1.22) for those with hyperuricaemia, respectively, after adjustments were made for age, sex, component number of metabolic syndrome and proteinuria. The adjusted HRs of cardiovascular mortality were 1.97 (95% CI 1.08, 3.59) for individuals with gout and 1.08 (95% CI 0.78, 1.51) for those with hyperuricaemia. Moreover, the risk of all-cause or cardiovascular mortality for gout remained unchanged when limiting the data to those with an estimated glomerular filtration of >60 ml/min/1.73 m(2).
This study demonstrates a link of gout, not hyperuricaemia, with a higher risk of death from all causes and cardiovascular diseases.
痛风和高尿酸血症与心血管疾病的关系已得到充分证实。本研究调查了痛风和高尿酸血症对生存的影响。
本研究的对象为台湾长庚纪念医院 2000 年至 2006 年进行的健康筛查计划的参与者。2000-07 年台湾国家死亡登记处确定了死亡状况和原因。采用 Cox 比例风险模型进行相关性分析。
在 61527 名受试者中，有 1383 人死亡（198 人死于心血管疾病），粗死亡率为每 1000 人年 4.86 人。血尿酸正常、高尿酸血症和痛风患者的粗死亡率分别为 4.50、5.61 和 10.46 人/1000 人年。校正年龄、性别、代谢综合征成分数和蛋白尿后，与血尿酸正常者相比，痛风患者全因死亡率的危险比（HR）分别为 1.46（95%可信区间 1.12,1.91），高尿酸血症患者的 HR 为 1.07（95%可信区间 0.94,1.22）。校正后痛风患者心血管死亡率的 HR 为 1.97（95%可信区间 1.08,3.59），高尿酸血症患者的 HR 为 1.08（95%可信区间 0.78,1.51）。此外，当将数据限制在估计肾小球滤过率>60ml/min/1.73m2 的患者时，痛风患者全因或心血管疾病死亡率的风险仍然不变。
本研究表明，痛风与全因和心血管疾病死亡风险增加有关，而高尿酸血症则无此关联。
