Sun Yujiao, Yu Xin, Zhi Ying, Geng Song, Li Hua, Liu Ting, Xu Ke, Chen Ling, Wu Chunwei, Qi Guoxian
Department of Cardiology of Aging, Department of Cardiology, The First Affiliated Hospital of China Medical University, NO,155 Nanjing North Street, Heping Ward, Shenyang 110001, China.
BMC Cardiovasc Disord. 2014 Aug 16;14:101. doi: 10.1186/1471-2261-14-101.
Although many studies have examined the relationship between uric acid (UA) and coronary artery disease (CAD), whether UA is an independent risk factor contributing to progression of CAD is still controversial. Whether UA plays a different role in different sexes is also unclear.
A total of 1116 individuals with suspected CAD were stratified into four groups according to their serum UA quartiles in total (men and women combined), in men, and in women. The association of UA with coronary atherosclerosis was assessed by univariable and multivariable logistic regression.
In total and in women, the prevalence of any plaques and significant/severe stenosis was significantly increased with an increase in quartiles of UA (all P < 0.05). The proportion of triple-vessel disease and left main artery lesion was highest in the fourth quartile (both p < 0.05). Increasing quartiles of UA were significantly associated with a coronary artery calcium score (CACS) >10 (all P < 0.01). As UA levels increased in women, the incidence of double-vessel lesions (p = 0.017) and the proportion of mixed plaques (p = 0.022) were significantly increased. The proportion of a CACS of 0 in total, in men and women was highest in the first quartile (all P < 0.01). UA was the strongest predictor of significant stenosis, multivessel disease, and mixed plaques in women (all p < 0.05). UA was the only risk factor for mixed plaques in total (P = 0.046).
The level of UA was significantly associated with coronary atherosclerosis in women, but not men.
尽管许多研究已经探讨了尿酸(UA)与冠状动脉疾病(CAD)之间的关系,但尿酸是否是导致CAD进展的独立危险因素仍存在争议。尿酸在不同性别中是否发挥不同作用也尚不清楚。
总共1116名疑似CAD患者根据其血清尿酸四分位数被分为四组,分别是总体(男性和女性合并)、男性和女性。通过单变量和多变量逻辑回归评估尿酸与冠状动脉粥样硬化的关联。
在总体以及女性中,随着尿酸四分位数的增加,任何斑块以及显著/严重狭窄的患病率均显著增加(所有P<0.05)。三支血管病变和左主干病变的比例在第四四分位数中最高(均p<0.05)。尿酸四分位数的增加与冠状动脉钙化评分(CACS)>10显著相关(所有P<0.01)。随着女性尿酸水平升高,双支血管病变的发生率(p = 0.017)和混合斑块的比例(p = 0.022)显著增加。总体、男性和女性中CACS为0的比例在第一四分位数中最高(所有P<0.01)。尿酸是女性中显著狭窄、多支血管病变和混合斑块的最强预测因子(所有p<0.05)。尿酸是总体中混合斑块的唯一危险因素(P = 0.046)。
尿酸水平与女性冠状动脉粥样硬化显著相关,但与男性无关。