Peng Tao-Chun, Wang Chung-Ching, Kao Tung-Wei, Chan James Yi-Hsin, Yang Ya-Hui, Chang Yaw-Wen, Chen Wei-Liang
Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, No. 325, Section 2, Chenggong Road, Neihu District, Taipei City 114, Taiwan.
Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, No. 325, Section 2, Chenggong Road, Neihu District, Taipei City 114, Taiwan ; Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital and School of Medicine, National Defense Medical Center, No. 325, Section 2, Chenggong Road, Neihu District,Taipei City 114, Taiwan.
Biomed Res Int. 2015;2015:127596. doi: 10.1155/2015/127596. Epub 2015 Jan 5.
Although the link between hyperuricemia and metabolic syndrome had been recognized, the association of the dyslipidemia among individuals with hyperuricemia remains not comprehensively assessed.
Using NHANES III study, we examined the relation between serum lipid profiles and different serum uric acid levels, including serum total cholesterol, LDL cholesterol, triglycerides, HDL cholesterol, apolipoprotein-B, lipoprotein (a), apolipoprotein AI, ratio of triglycerides to HDL cholesterol, and ratio of apolipoprotein-B to AI.
After adjusting for potential confounders, average differences (95% confidence interval) comparing the top to the bottom (reference) serum uric acid were 0.29 (0.19, 0.39) mmol/L for total cholesterol, 0.33 (0.26, 0.41) mmol/L for triglycerides, 0.14 (0.01, 0.27) mmol/L for LDL cholesterol, -0.08 (-0.11, -0.05) mmol/L for HDL, and 0.09 (0.05, 0.12) g/L for serum apolipoprotein-B. Notably, ratios of triglycerides to HDL cholesterol and apolipoprotein-B to AI were also linearly associated with uric acid levels (P for trend < 0.001).
This study suggested that serum LDL cholesterol, triglycerides, total cholesterol, apolipoprotein-B levels, ratio of triglycerides to HDL cholesterol, and ratio of apolipoprotein-B to AI are strongly associated with serum uric acid levels, whereas serum HDL cholesterol levels are significantly inversely associated. In the clinical practice, the more comprehensive strategic management to deal with dyslipidemia and hyperuricemia deserves further investigation.
尽管高尿酸血症与代谢综合征之间的联系已得到认可，但高尿酸血症患者血脂异常的关联仍未得到全面评估。
利用美国国家健康与营养检查调查（NHANES）III研究，我们研究了血清脂质谱与不同血清尿酸水平之间的关系，包括血清总胆固醇、低密度脂蛋白胆固醇、甘油三酯、高密度脂蛋白胆固醇、载脂蛋白B、脂蛋白（a）、载脂蛋白AI、甘油三酯与高密度脂蛋白胆固醇的比值以及载脂蛋白B与AI的比值。
在对潜在混杂因素进行调整后，血清尿酸水平最高组与最低组（参照组）相比的平均差异（95%置信区间）为：总胆固醇0.29（0.19，0.39）mmol/L，甘油三酯0.33（0.26，0.41）mmol/L，低密度脂蛋白胆固醇0.14（0.01，0.27）mmol/L，高密度脂蛋白-0.08（-0.11，-0.05）mmol/L，血清载脂蛋白B 0.09（0.05，0.12）g/L。值得注意的是，甘油三酯与高密度脂蛋白胆固醇的比值以及载脂蛋白B与AI的比值也与尿酸水平呈线性相关（趋势P<0.001）。
本研究表明，血清低密度脂蛋白胆固醇、甘油三酯、总胆固醇、载脂蛋白B水平、甘油三酯与高密度脂蛋白胆固醇的比值以及载脂蛋白B与AI的比值与血清尿酸水平密切相关，而血清高密度脂蛋白胆固醇水平则呈显著负相关。在临床实践中，应对血脂异常和高尿酸血症的更全面策略性管理值得进一步研究。
