Department of Internal Medicine, School of Medical Sciences, State University of Campinas, São Paulo, Brazil.
BMC Cardiovasc Disord. 2012 Jul 16;12:52. doi: 10.1186/1471-2261-12-52.
The impact of serum uric acid (SUA) on arteries of hypertensive subjects remains to be fully established. This study investigated the relationship between SUA and carotid structural and hemodynamic parameters in hypertensive men and women.
Three hundred and thirty eight patients (207 women and 131 men) were cross-sectionally evaluated by clinical, laboratory, hemodynamic and carotid ultrasound analysis. Common carotid diameters, circumferential wall tensions, Young's Elastic Modulus, Stiffness Index, Arterial Compliance and intima-media thickness (IMT) were determined. Internal carotid artery resistive index (ICRI), a hemodynamic measure that reflects local vascular impedance and microangiopathy, was also assessed.
Univariate analysis showed no significant correlation of SUA with carotid diameters, elasticity/stiffness indexes, IMT and circumferential wall tensions in both genders. Conversely, SUA correlated with ICRI (r=0.34; p<0.001) in women, but not in men, and hyperuricemic women presented higher ICRI than normouricemic ones (0.684 ± 0.007 vs. 0.649 ± 0.004; p<0.001). Stepwise and logistic regression analyses adjusted for potential confounding factors showed that ICRI was independently associated with SUA and hyperuricemia in women.
This study demonstrated that SUA was associated with ICRI in hypertensive women, suggesting that there might gender-related differences in the relationship between SUA and vascular damage in subjects with systemic hypertension.
血清尿酸(SUA)对高血压患者动脉的影响尚未完全确定。本研究调查了 SUA 与高血压男女颈动脉结构和血流动力学参数之间的关系。
通过临床、实验室、血流动力学和颈动脉超声分析,对 338 例患者(207 名女性和 131 名男性)进行了横断面评估。确定颈总动脉直径、周向壁张力、杨氏弹性模量、僵硬度指数、动脉顺应性和内膜中层厚度(IMT)。还评估了反映局部血管阻抗和微血管病变的颈内动脉阻力指数(ICRI)这一血流动力学指标。
单因素分析显示,SUA 与两性的颈动脉直径、弹性/僵硬指数、IMT 和周向壁张力均无显著相关性。相反,SUA 与女性的 ICRI 相关(r=0.34;p<0.001),但与男性无关,且高尿酸血症女性的 ICRI 高于正常尿酸血症女性(0.684 ± 0.007 比 0.649 ± 0.004;p<0.001)。经潜在混杂因素调整的逐步和逻辑回归分析显示,ICRI 与 SUA 和女性高尿酸血症独立相关。
本研究表明,SUA 与高血压女性的 ICRI 相关,提示在患有系统性高血压的人群中,SUA 与血管损伤之间的关系可能存在性别差异。