Center for Stroke Research Berlin and Applied Cachexia Research, Department of Cardiology, Charite Universitätsmedizin Berlin, Berlin, Germany.
Semin Nephrol. 2011 Sep;31(5):433-40. doi: 10.1016/j.semnephrol.2011.08.007.
The association between increased uric acid (UA) levels and cardiovascular disease (CVD) has been observed and studied for many decades. The value of UA as an independent factor within the metabolic risk profile for prediction of CVD in the normal population remains an issue of ongoing discussion. In turn, increasing evidence suggests that among patients with established CVD such as heart failure UA is an independent marker of disease state and prognosis. Increased UA levels may be an indicator of up-regulated activity of xanthine oxidase, a powerful oxygen radical-generating system in human physiology. Increased reactive oxygen species (ROS) accumulation contributes to endothelial dysfunction, metabolic and functional impairment, inflammatory activation, and other features of cardiovascular pathophysiology. Accordingly, inhibition of xanthine oxidase activity has been shown to improve a range of surrogate markers in patients with CVD, but this effect seems to be confined to hyperuricemic patients because disappointing results were reported in studies with normouricemic patients. In this review we summarize current evidence on hyperuricemia in CVD. The value of UA as a biomarker and as a potential therapeutic target for tailored metabolic treatment in CVD is discussed.
几十年来，人们一直观察和研究尿酸（UA）水平升高与心血管疾病（CVD）之间的关系。UA 作为代谢风险谱中 CVD 预测的独立因素的价值仍然是一个持续讨论的问题。相反，越来越多的证据表明，在心力衰竭等已确诊的 CVD 患者中，UA 是疾病状态和预后的独立标志物。UA 水平升高可能表明黄嘌呤氧化酶活性上调，黄嘌呤氧化酶是人体生理学中一种强大的氧自由基生成系统。活性氧（ROS）的积累会导致内皮功能障碍、代谢和功能障碍、炎症激活以及心血管病理生理学的其他特征。因此，抑制黄嘌呤氧化酶的活性已被证明可以改善 CVD 患者的一系列替代标志物，但这种效果似乎仅限于高尿酸血症患者，因为在正常尿酸血症患者的研究中报告了令人失望的结果。在这篇综述中，我们总结了 CVD 中高尿酸血症的现有证据。讨论了 UA 作为生物标志物和潜在的治疗靶点在 CVD 中的代谢治疗中的价值。
