Yoshimura Ayako, Adachi Hisashi, Hirai Yuji, Enomoto Mika, Fukami Ako, Kumagai Eita, Ohbu Kyoko, Nakamura Sachiko, Obuchi Aya, Nohara Yume, Imaizumi Tsutomu
Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine.
Int Heart J. 2014;55(1):65-70. doi: 10.1536/ihj.13-170. Epub 2014 Jan 27.
The association of serum uric acid (UA) with left ventricular hypertrophy (LVH) remains controversial. We investigated this issue in a general population. Participants consisted of 1,943 subjects (774 males and 1,169 females) aged over 40 years, living in Tanushimaru (a Japanese cohort of the Seven Countries Study). Serum UA and other biochemistry parameters were determined by a standard analytical technique. All individuals underwent anthropometric measurements and 2-dimensional echocardiography. Because serum UA levels are much higher in males than in females, they were analyzed separately. When LV mass index (LVMI) levels were stratified according to tertile as low (≤ 80 cm(2): n = 261), middle (81-103 cm(2): n = 261), and high (≥ 104 cm(2): n = 252) in males, there were significant relationships between LVMI and UA, in addition to age, body mass index, systolic blood pressure, medication for hypertension, triglycerides, and alcohol intake. Multiple stepwise regression analysis revealed LVMI was significantly associated with systolic BP (P < 0.0001), medication for hypertension (P < 0.0001), UA (P = 0.003), BMI (P = 0.019), and alcohol intake (P = 0.038) in males. In females, LVMI was not associated with UA. In a multiple logistic regression analysis, a significantly higher odds ratio of LVH (odds ratio: 1.77, 95%CI: 1.01-3.09, P < 0.05) was observed for males in the highest UA tertile versus the lowest UA tertile after adjustments for confounding factors, but not for females. In this cross-sectional study, there was a clear difference in the relation of UA and LVH between males and females. High serum UA was significantly and independently associated with LVH evaluated by echocardiography in only males of a general population.
血清尿酸(UA)与左心室肥厚(LVH)之间的关联仍存在争议。我们在一般人群中对这个问题进行了调查。研究对象包括居住在种子丸(七国研究中的一个日本队列)的1943名40岁以上的受试者(774名男性和1169名女性)。血清尿酸和其他生化参数通过标准分析技术测定。所有个体均接受人体测量和二维超声心动图检查。由于男性血清尿酸水平远高于女性,因此对其进行了单独分析。当男性左心室质量指数(LVMI)水平按三分位数分层为低(≤80 cm²:n = 261)、中(81 - 103 cm²:n = 261)和高(≥104 cm²:n = 252)时,除了年龄、体重指数、收缩压、高血压用药、甘油三酯和酒精摄入量外,LVMI与尿酸之间存在显著关系。多元逐步回归分析显示,男性的LVMI与收缩压(P < <0.0001)、高血压用药(P < <0.0001)、尿酸(P = 0.003)、体重指数(P = 0.019)和酒精摄入量(P = 0.038)显著相关。在女性中,LVMI与尿酸无关。在多元逻辑回归分析中,在对混杂因素进行调整后,观察到男性中尿酸最高三分位数组与最低三分位数组相比,LVH的优势比显著更高(优势比:1.77,95%置信区间:1.01 - 3.09,P < <0.05),但女性并非如此。在这项横断面研究中,男性和女性在尿酸与LVH的关系上存在明显差异。在一般人群中,仅男性的高血清尿酸与通过超声心动图评估的LVH显著且独立相关。