Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy.
Dipartimento Biomedico di Medicina Interna e Specialistica (DIBIMIS), Unit of Nephrology and Hypertension, European Society of Hypertension Excellence Centre, Università di Palermo, Palermo, Italy.
Nutr Metab Cardiovasc Dis. 2014 Jul;24(7):744-50. doi: 10.1016/j.numecd.2014.01.014. Epub 2014 Jan 29.
Clinical studies exploring the relationship between serum uric acid (SUA) and arterial stiffness yielded conflicting results. Only in a few of these studies, arterial distensibility was examined by measuring aortic pulse wave velocity (PWV), which is considered the gold standard for evaluating arterial stiffness. In none of the previous investigations was the influence of SUA on aortic distensibility assessed, taking into account the effect of albuminuria. The purpose of our study was to comprehensively analyse the relationships between SUA and aortic PWV in a group of essential hypertensive patients.
We enrolled 222 untreated and uncomplicated hypertensive subjects (mean age: 44 ± 10 years; 60% males), without gout. In all patients, SUA and urinary albumin excretion rate (AER) were determined. Moreover, carotid-femoral (c-f) PWV was measured. C-f PWV was significantly higher in hypertensive patients belonging to the uppermost tertile of SUA distribution, compared to subjects of the lowest tertiles (10.9 ± 2.2 vs. 10 ± 1.8 vs. 9.9 ± 1.7 m s(-1); p = 0.001). In univariate analysis, SUA correlated with c-f PWV (r = 0.24; p < 0.001). This association disappeared when AER was added in a multiple regression model, including SUA, age, mean arterial pressure, gender, metabolic syndrome components and glomerular filtration rate.
The results of our study showed that, in essential hypertensive subjects, there is a positive relationship between mild hyperuricaemia and aortic stiffness. This association weakened after adjustment for covariates and lost statistical significance after further correction for albuminuria.
探索血清尿酸（SUA）与动脉僵硬度之间关系的临床研究结果相互矛盾。在这些研究中，只有少数研究通过测量主动脉脉搏波速度（PWV）来检查动脉可扩张性，而 PWV 被认为是评估动脉僵硬度的金标准。在之前的研究中，没有一项研究考虑到蛋白尿的影响，评估 SUA 对主动脉可扩张性的影响。我们的研究目的是在一组原发性高血压患者中全面分析 SUA 与主动脉 PWV 之间的关系。
我们纳入了 222 名未经治疗且无并发症的高血压患者（平均年龄：44±10 岁；60%为男性），均无痛风。所有患者均测定了 SUA 和尿白蛋白排泄率（AER）。此外，还测量了颈股（c-f）PWV。与 SUA 分布最低三分位数的患者相比，SUA 分布最高三分位数的高血压患者的 c-f PWV 显著更高（10.9±2.2 比 10±1.8 比 9.9±1.7 m/s；p=0.001）。在单因素分析中，SUA 与 c-f PWV 相关（r=0.24；p<0.001）。当将 SUA、年龄、平均动脉压、性别、代谢综合征成分和肾小球滤过率纳入多元回归模型后，这种相关性消失。
我们的研究结果表明，在原发性高血压患者中，轻度高尿酸血症与主动脉僵硬度之间存在正相关关系。在调整协变量后，这种相关性减弱，进一步校正白蛋白尿后，这种相关性失去统计学意义。
