Zhan Yiqiang, Dong Ying, Tang Zheng, Zhang Fen, Hu Dayi, Yu Jinming
Institute of Clinical Epidemiology, School of Public Health, Fudan University, Shanghai, P. R. China.
Department of Preventive Medicine, School of Basic Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, P. R. China.
Angiology. 2015 Aug;66(7):687-91. doi: 10.1177/0003319714566228. Epub 2015 Jan 6.
Uric acid (UA) has been reported to be associated with cardiovascular disease (CVD) in caucasians. However, it is unclear whether this association remains significant in a Chinese population. The present study aimed to investigate the association between UA and low ankle brachial index (ABI), a measurement of peripheral arterial disease, in Chinese patients. A total of 6262 hospital-based patients with high CVD risk were enrolled. Low ABI was defined as ABI ≤0.9 in either side. Low ABI was detected in 1390 (22.2%) patients. Higher UA was significantly associated with higher risk of low ABI and modified by gender (P = .0045). After adjusting for age, body mass index, total cholesterol, triglyceride, low-density lipoprotein, high-density lipoprotein, fasting glucose, hypertension, and smoking, participants in the highest quartile of UA exhibited 37% (odds ratio [OR]:1.37, 95% confidence interval [CI]: 1.03-1.82) higher risk of low ABI compared to those in the lowest quartile in men, while OR (95% CI) was 1.69 (1.29-2.22) for women. However, when kidney function was further adjusted, the associations were attenuated in both men and women and were significant only in women. The results were suggestive of higher UA associating with higher risk of low ABI in women, and the association was largely driven by kidney function, especially in men.
据报道，在高加索人群中尿酸（UA）与心血管疾病（CVD）有关。然而，这种关联在中国人中是否仍然显著尚不清楚。本研究旨在调查中国患者中UA与低踝臂指数（ABI，一种外周动脉疾病的测量指标）之间的关联。共纳入了6262名具有高心血管疾病风险的住院患者。低ABI定义为任一侧ABI≤0.9。1390名（22.2%）患者检测到低ABI。较高的UA与低ABI风险较高显著相关，且受性别影响（P = 0.0045）。在调整年龄、体重指数、总胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白、空腹血糖、高血压和吸烟因素后，与最低四分位数的男性相比，UA最高四分位数的男性出现低ABI的风险高37%（优势比[OR]：1.37，95%置信区间[CI]：1.03 - 1.82），而女性的OR（95%CI）为1.69（1.29 - 2.22）。然而，当进一步调整肾功能后，男性和女性的这种关联均减弱，且仅在女性中显著。结果提示女性中较高的UA与低ABI风险较高相关，且这种关联在很大程度上受肾功能驱动，尤其是在男性中。
