From General Internal Medicine, Cleveland Clinic Medicine Institute, Cleveland, OH.
MedStar Health Research Institute, Hyattsville, MD.
J Clin Hypertens (Greenwich). 2012 Feb;14(2):71-77. doi: 10.1111/j.1751-7176.2011.00574.x. Epub 2012 Jan 4.
It is unknown what role uric acid (UA) may play in the increasing rates of cardiovascular disease (CVD) among Alaska Eskimos. UA is associated with both hypertension (HTN) and chronic kidney disease (CKD). The authors analyzed 1078 Genetics of Coronary Artery Disease in Alaska Natives (GOCADAN) participants. Estimated glomerular filtration rate (eGFR) was calculated from serum creatinine measures using the Modification of Diet in Renal Disease equation. CKD was defined by an eGFR of <60 mL/min/1.73 m(2) . The authors adjusted for age, sex, education, diabetes, hypertension (or eGFR), obesity, lipids, and smoking status; 7% (n=75) had prevalent CKD. eGFR decreased with increasing tertiles of serum UA (P<.001). UA was independently associated with prevalent CKD (adjusted odds ratio [OR] and 95% confidence interval [CI] of 2.04 (1.62-2.56), respectively). Twenty-one percent (n=230) had prevalent HTN and UA was independently associated with prevalent HTN (adjusted OR, 1.2; 95% CI, 1.1-1.5). UA is independently associated with prevalent CKD and HTN in this population.
尿酸(UA)在导致阿拉斯加爱斯基摩人中心血管疾病(CVD)发病率上升的过程中可能扮演了什么角色,目前尚不清楚。UA 与高血压(HTN)和慢性肾脏病(CKD)都有关联。作者分析了 1078 名阿拉斯加原住民冠状动脉疾病遗传学(GOCADAN)参与者的数据。通过使用肾脏病饮食改良公式,根据血清肌酐测量结果估算肾小球滤过率(eGFR)。CKD 通过 eGFR<60 mL/min/1.73 m(2) 来定义。作者对年龄、性别、教育程度、糖尿病、高血压(或 eGFR)、肥胖、血脂和吸烟状况进行了调整;7%(n=75)存在现患 CKD。随着血清 UA 三分位值的升高,eGFR 逐渐降低(P<.001)。UA 与现患 CKD 独立相关(调整后的优势比[OR]和 95%置信区间[CI]分别为 2.04(1.62-2.56))。21%(n=230)存在现患 HTN,UA 与现患 HTN 独立相关(调整后的 OR,1.2;95% CI,1.1-1.5)。在该人群中,UA 与现患 CKD 和 HTN 独立相关。