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血脂异常的阿拉伯人群血尿酸水平的影响因素。

Determinants of blood uric acid levels in a dyslipidemic Arab population.

机构信息

Kuwait University Faculty of Medicine, Jabriya, Kuwait.

出版信息

Med Princ Pract. 2012;21(3):209-16. doi: 10.1159/000333483. Epub 2011 Nov 17.

Abstract

OBJECTIVES

The objective of this study was to explore the relationships between circulating uric acid and lipid levels and components of the metabolic syndrome (MetS) in Arab dyslipidemic patients, a group already at high coronary artery disease risk.

SUBJECTS AND METHODS

The medical records of 1,229 subjects (632 men, 597 women) referred for treatment of dyslipidemia and followed up for at least 12 months were reviewed. Serum levels of uric acid and lipids (total cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein) and other variables in the National Cholesterol Education Program ATP III criteria definition of MetS were assessed at initial presentation and every 4- 6 months, under specific lipid-lowering treatment (statins and/or fibrates), in each of the subjects. Their respective associations were explored by appropriate logistic regression techniques with control for confounding risk factors, including age, gender and body mass index.

RESULTS

306 subjects (24.9%) of the study population were hyperuricemic; they were more likely to be men, obese and diabetic. Also the serum uric acid level (mean ± SD) was greater in men with MetS compared with men without (377.0 ± 98.0 vs. 361.6 ± 83.1 μmol/l, p < 0.05), an observation not reproduced in women. Uric acid levels had significant associations with the presence of fasting hyperglycemia, hypertension and large waist circumference (WC) in men, but only with large WC in women. With statin treatment, uric acid levels decreased by 10% within 1 year of treatment; with fibrates, uric acid levels remained unchanged or slightly increased.

CONCLUSION

The data showed that hyperuricemia is common in dyslipidemic patients in Kuwait, where its important determinants are male sex, obesity, diabetes and statin treatment.

摘要

目的

本研究旨在探讨阿拉伯血脂异常患者循环尿酸和血脂水平及代谢综合征(MetS)成分之间的关系,这些患者已经处于高冠心病风险状态。

方法

回顾了 1229 名(632 名男性,597 名女性)因血脂异常就诊并至少随访 12 个月的患者的病历。在初始检查时以及在接受特定降脂治疗(他汀类药物和/或贝特类药物)期间的每 4-6 个月,根据国家胆固醇教育计划 ATP III 标准中 MetS 的定义,评估了尿酸和血脂(总胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白)及其他变量的血清水平。通过适当的逻辑回归技术,在控制混杂风险因素(包括年龄、性别和体重指数)的情况下,探讨了它们之间的相关性。

结果

研究人群中 306 名(24.9%)患者为高尿酸血症;他们更可能是男性、肥胖和糖尿病患者。此外,患有 MetS 的男性的血清尿酸水平(均值±标准差)高于无 MetS 的男性(377.0±98.0 与 361.6±83.1 μmol/L,p<0.05),而女性则没有这种情况。尿酸水平与男性空腹高血糖、高血压和大腰围(WC)的存在具有显著相关性,但仅与女性的大 WC 相关。在接受他汀类药物治疗后,尿酸水平在 1 年内下降了 10%;而接受贝特类药物治疗后,尿酸水平保持不变或略有升高。

结论

数据表明,高尿酸血症在科威特的血脂异常患者中很常见,其重要决定因素是男性、肥胖、糖尿病和他汀类药物治疗。

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