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血清尿酸与社区人群肾脏损害的关系:高畑研究。

The association between serum uric acid and renal damage in a community-based population: the Takahata study.

机构信息

Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.

出版信息

Clin Exp Nephrol. 2013 Aug;17(4):541-8. doi: 10.1007/s10157-012-0743-y. Epub 2012 Nov 27.

Abstract

BACKGROUND

Hyperuricemia is a risk factor for end-stage renal disease. This study examined the association between serum uric acid and renal damage in a community-based population.

METHODS

In this study 3126 subjects without renal insufficiency were recruited at baseline and were followed for one year. The urinary albumin-creatinine ratio (UACR) and β2-microglobulin-creatinine ratio (UBCR) in morning spot urine samples were used as indices of either glomerular (UACR) or tubular (UBCR) damage.

RESULTS

The mean value of serum uric acid (mg/dL) was 5.8 ± 1.3 (SD) in men and 4.5 ± 1.1 in women. In cross-sectional analysis the increased serum uric acid levels were accompanied by higher UACR values in both men and women (P < 0.01). In contrast, UBCR values were reduced when uric acid levels increased in both men and women (P < 0.01). Multivariate analysis revealed that albuminuria (UACR ≥ 30 mg/g) was significantly associated with increased uric acid (≥7 mg/dL for men, ≥6 mg/dL for women). High UBCR (≥300 μg/g) was negatively associated with uric acid in men, but not in women, after adjustment for possible confounders. In longitudinal analysis in 1388 subjects multiple linear regression analysis showed that uric acid at baseline was an independent factor for one-year increase of UACR [coefficient 4.80 (95 % confidence interval 0.40-9.33) (mg/g) per 1 mg/dL increase in uric acid, P = 0.033].

CONCLUSION

This study showed that serum uric acid concentration was positively associated with UACR, suggesting that uric acid may be related to glomerular damage in a community-based population.

摘要

背景

高尿酸血症是终末期肾病的一个危险因素。本研究在一个基于社区的人群中考察了血清尿酸与肾损害之间的关系。

方法

本研究共纳入了 3126 名无肾功能不全的受试者,在基线时进行了研究,并随访了一年。晨尿中白蛋白/肌酐比值(UACR)和β2-微球蛋白/肌酐比值(UBCR)用于肾小球(UACR)或肾小管(UBCR)损害的指标。

结果

男性血清尿酸(mg/dL)的平均值为 5.8 ± 1.3(SD),女性为 4.5 ± 1.1。在横断面分析中,男性和女性的血清尿酸水平升高均伴有 UACR 值的升高(P < 0.01)。相反,当尿酸水平升高时,男性和女性的 UBCR 值均降低(P < 0.01)。多变量分析显示,白蛋白尿(UACR≥30 mg/g)与尿酸升高显著相关(男性尿酸≥7 mg/dL,女性尿酸≥6 mg/dL)。在调整了可能的混杂因素后,高 UBCR(≥300 μg/g)与男性的尿酸呈负相关,但与女性无关。在 1388 名受试者的纵向分析中,多元线性回归分析显示,基线时的尿酸是 UACR 一年增加的独立因素[尿酸每增加 1 mg/dL,UACR 增加 4.80(95%置信区间 0.40-9.33)(mg/g),P = 0.033]。

结论

本研究表明,血清尿酸浓度与 UACR 呈正相关,提示尿酸可能与社区人群的肾小球损害有关。

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