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高尿酸血症是中老年人群中新发微量白蛋白尿的独立危险因素:一项来自台湾的前瞻性队列研究。

Hyperuricemia is an independent risk factor for new onset micro-albuminuria in a middle-aged and elderly population: a prospective cohort study in taiwan.

机构信息

Department of Nephrology, Chang Gung Memorial Hospital, Chiayi, Taiwan.

出版信息

PLoS One. 2013 Apr 24;8(4):e61450. doi: 10.1371/journal.pone.0061450. Print 2013.

DOI:10.1371/journal.pone.0061450
PMID:23637835
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3634806/
Abstract

BACKGROUND

Hyperuricemia is now regarded as a risk factor for cardiovascular disease. Micro-albuminuria is associated with increased risk for cardiovascular disease and chronic kidney disease. We hypothesized that elevated serum uric acid (UA) is associated with development of micro-albuminuria in the general population.

METHODOLOGY/PRINCIPAL FINDINGS: We conducted a community-based prospective cohort study. A total of 1862 subjects from southern Taiwan, all older than 40 years, were screened and 993 of these participants without micro-albuminuria were followed for 4 years. Urinary albumin-to-creatinine ratio was measured two times per year. A multiple linear regression model indicated that serum UA was independently associated with ln(ACR) after adjustment for 8 factors (age, sex, and 6 metabolic metrics) (β = 0.194, p<0.01). Logistic regression analysis indicated that each 1 mg/dL increase of UA was associated with a 1.42-fold increased risk of micro-albuminuria after adjustment for the same 8 factors (OR = 1.42, 95% CI: 1.27-1.59, p<0.01). A Cox regression model using subjects with serum UA less than 5 mg/dL as reference group indicated higher hazard ratios (HRs) only found in subjects with serum UA more than 7 mg/dL (HR = 3.54, 95% CI: 2.11-5.93, p<0.01) and not in subjects with serum UA of 5 to 7 mg/dL (HR = 1.30, 95% CI: 0.82-2.07, p = 0.15).

CONCLUSION

Hyperuricemia is significantly associated with micro-albuminuria in middle-aged and elderly males and females from a general population in Taiwan. Elevated serum UA is an independent predictor for development of micro-albuminuria in this population.

摘要

背景

高尿酸血症现在被认为是心血管疾病的一个危险因素。微量白蛋白尿与心血管疾病和慢性肾脏病的风险增加有关。我们假设血清尿酸(UA)升高与一般人群中微量白蛋白尿的发展有关。

方法/主要发现:我们进行了一项基于社区的前瞻性队列研究。在台湾南部,总共筛选了 1862 名年龄均在 40 岁以上的受试者,其中 993 名无微量白蛋白尿的受试者在 4 年内进行了随访。每年两次测量尿白蛋白与肌酐比值。在调整了 8 个因素(年龄、性别和 6 个代谢指标)后,多元线性回归模型表明血清 UA 与 ln(ACR)独立相关(β=0.194,p<0.01)。Logistic 回归分析表明,在调整了相同的 8 个因素后,UA 每增加 1mg/dL,微量白蛋白尿的风险增加 1.42 倍(OR=1.42,95%CI:1.27-1.59,p<0.01)。以血清 UA 低于 5mg/dL 的受试者为参考组的 Cox 回归模型表明,仅在血清 UA 高于 7mg/dL 的受试者中发现更高的风险比(HR)(HR=3.54,95%CI:2.11-5.93,p<0.01),而在血清 UA 为 5 至 7mg/dL 的受试者中则没有(HR=1.30,95%CI:0.82-2.07,p=0.15)。

结论

高尿酸血症与台湾一般人群中中年和老年男女的微量白蛋白尿显著相关。血清 UA 升高是该人群微量白蛋白尿发展的独立预测因子。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9562/3634806/9b92299a4eb4/pone.0061450.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9562/3634806/cfb41cbbfa5d/pone.0061450.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9562/3634806/9b92299a4eb4/pone.0061450.g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9562/3634806/cfb41cbbfa5d/pone.0061450.g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9562/3634806/9b92299a4eb4/pone.0061450.g002.jpg

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