Tamariz Leonardo, Hernandez Fernando, Bush Aaron, Palacio Ana, Hare Joshua M
Department of Medicine, Miller School of Medicine, University of Miami, Miami, Florida; Veterans Affairs Medical Center, Miami, Florida.
Department of Medicine, Miller School of Medicine, University of Miami, Miami, Florida; Veterans Affairs Medical Center, Miami, Florida.
Heart Rhythm. 2014 Jul;11(7):1102-8. doi: 10.1016/j.hrthm.2014.04.003. Epub 2014 Apr 5.
Atrial fibrillation (AF) is mediated by oxidative stress, neurohormonal activation, and inflammatory activation. Serum uric acid (SUA) is a surrogate marker of oxidative stress. Xanthine oxidase produces SUA and is upregulated by inflammation and neurohormones.
To perform a meta-analysis to evaluate the evidence supporting an association between AF and SUA.
We searched the MEDLINE database (1966 to 2013) supplemented by manual searches of bibliographies of key relevant articles. We selected all cross-sectional and cohort studies in which SUA was measured and AF was reported. In cross-sectional studies, we calculated the pooled standardized mean difference of SUA between those with AF and those without AF. In cohort studies, we calculated the pooled relative risk with the corresponding 95% confidence interval (CI) for incident AF by using the random effects method.
The search strategy yielded 40 studies, of which only 9 met our eligibility criteria. The 6 cross-sectional studies comprised 7930 evaluable patients with a median prevalence of heart failure of 4% (IQR 0%-100%). The standardized mean difference of SUA for those with AF was 0.42 (95% CI 0.27-0.58) compared with those without AF. The 3 cohort studies evaluated 138,306 individuals without AF. The relative risk of having AF for those with high SUA was 1.67 (95% CI 1.23-2.27) compared with those with normal SUA.
High SUA is associated with AF in both cross-sectional and cohort studies. It is unclear whether SUA represents a disease marker or a treatment target.
房颤（AF）由氧化应激、神经激素激活和炎症激活介导。血清尿酸（SUA）是氧化应激的替代标志物。黄嘌呤氧化酶产生SUA，并受炎症和神经激素上调。
进行一项荟萃分析，以评估支持AF与SUA之间关联的证据。
我们检索了MEDLINE数据库（1966年至2013年），并辅以手动检索关键相关文章的参考文献。我们选择了所有测量了SUA并报告了AF的横断面研究和队列研究。在横断面研究中，我们计算了AF患者与非AF患者之间SUA的合并标准化平均差。在队列研究中，我们采用随机效应方法计算了发生AF的合并相对风险及相应的95%置信区间（CI）。
检索策略产生了40项研究，其中只有9项符合我们的纳入标准。6项横断面研究包括7930例可评估患者，心力衰竭的中位患病率为4%（四分位间距0%-100%）。与非AF患者相比，AF患者的SUA标准化平均差为0.42（95%CI 0.27-0.58）。3项队列研究评估了138,306例无AF的个体。与SUA正常的个体相比，SUA高的个体发生AF的相对风险为1.67（95%CI 1.23-2.27）。
在横断面研究和队列研究中，高SUA均与AF相关。尚不清楚SUA是代表疾病标志物还是治疗靶点。
