Department of Internal Medicine A, The Chaim Sheba Medical Center, Tel Hashomer, Israel.
Am J Cardiol. 2013 Apr 15;111(8):1146-51. doi: 10.1016/j.amjcard.2012.12.034. Epub 2013 Jan 24.
Studies in different populations with high risk for cardiovascular disease (CVD) have shown an association between serum uric acid (SUA) and CVD. However, only a few studies have demonstrated such an association in healthy populations. The aim of this study was to investigate the association between SUA and CVD in a cohort of men and women without diabetes or CVD. A retrospective study was conducted, with a mean 4.8-year follow-up. The outcome was the occurrence of a cardiovascular event, defined as the diagnosis of ischemic heart disease, acute coronary syndrome, acute myocardial infarction, or ischemic stroke. Mean SUA levels were 6.2 ± 1.1 mg/dl for men (n = 6,580) and 4.4 ± 1.1 mg/dl for women (n = 2,559). For women, the rate of CVD occurrence was 11.6% for the highest quartile of SUA level, compared with 5.0% to 6.5% for the lower 3 quartiles. For men, the rate of CVD occurrence was 14.0% for the highest quartile of SUA level, compared with 10.8% for the lowest quartile. The hazard ratio for CVD, adjusted for age, serum creatinine level, body mass index, systolic blood pressure, low-density lipoprotein cholesterol level, triglyceride level, plasma fasting glucose, physical activity, cardiovascular family history, use of diuretics, and current smoking, was 1.24 (95% confidence interval 1.08 to 1.41) for women and 1.06 (95% confidence interval 1.00 to 1.13) for men (p for interaction = 0.04). In conclusion, the strong association of SUA levels with CVD in women, compared with the much lesser degree in men, highlights the necessity of stratifying by gender in investigations of cardiovascular risk factors and supports exploration of SUA as a marker of CVD risk in healthy populations.
在患有心血管疾病（CVD）风险较高的不同人群中进行的研究表明，血清尿酸（SUA）与 CVD 之间存在关联。然而，只有少数研究在健康人群中证明了这种关联。本研究旨在调查无糖尿病或 CVD 的男性和女性队列中 SUA 与 CVD 之间的关系。进行了一项回顾性研究，平均随访时间为 4.8 年。结果是发生心血管事件，定义为缺血性心脏病、急性冠状动脉综合征、急性心肌梗死或缺血性中风的诊断。男性（n=6580）的平均 SUA 水平为 6.2±1.1mg/dl，女性（n=2559）的平均 SUA 水平为 4.4±1.1mg/dl。对于女性，SUA 水平最高四分位数的 CVD 发生率为 11.6%，而较低的 3 个四分位数为 5.0%至 6.5%。对于男性，SUA 水平最高四分位数的 CVD 发生率为 14.0%，而最低四分位数为 10.8%。经年龄、血清肌酐水平、体重指数、收缩压、低密度脂蛋白胆固醇水平、甘油三酯水平、血浆空腹血糖、体力活动、心血管家族史、利尿剂使用和当前吸烟调整后，女性 CVD 的危险比为 1.24（95%置信区间为 1.08 至 1.41），男性为 1.06（95%置信区间为 1.00 至 1.13）（p 交互=0.04）。总之，与男性相比，SUA 水平与女性 CVD 的强关联突出了在心血管危险因素研究中按性别分层的必要性，并支持将 SUA 作为健康人群 CVD 风险的标志物进行探索。
