Cohen Eytan, Levi Amos, Vecht-Lifshitz Susan E, Goldberg Elad, Garty Moshe, Krause Ilan
From the *Department of Medicine F. Recanati, and †Clinical Pharmacology Unit, Rabin Medical Center, Beilinson Campus, Petah Tikva; ‡Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv; and §Recanati Center for Preventive Medicine, Rabin Medical Center, Beilinson Campus, Petah Tikva, Israel.
J Investig Med. 2015 Mar;63(3):534-8. doi: 10.1097/JIM.0000000000000152.
BACKGROUND/AIM: Hyperhomocysteinemia and hyperuricemia are both considered risk factors for coronary artery disease. However, the relationship between the 2 has not yet been thoroughly investigated. This study aimed to evaluate this relationship more closely.
This study is a retrospective cross-sectional analysis of data from a screening center in Israel assessing 16,477 subjects, within an age range of 20 to 80 years.
The mean age of the study sample was 46 years, and 68% were males. Hyperuricemia was found in 24.9% and 14.6% of subjects with elevated and normal homocysteine serum levels, respectively (P < 0.001). A positive association was found between homocysteine serum levels and uric acid serum levels. Compared with subjects with normal homocysteine serum levels, those with hyperhomocysteinemia had an odds ratio (OR) for hyperuricemia of 1.7 (95% confidence interval [CI], 1.5-1.9) and 1.6 (95% CI, 1.1-2.5) for males and females, respectively. After multivariate adjustment for age, hypertension, body mass index, estimated glomerular filtration rate, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and thiazide use, the association remained significant in males (OR, 1.5; 95% CI, 1.3-1.7; P < 0.001) but not in females (OR, 0.9; 95% CI, 0.6-1.6; P = 0.82).
This large cohort showed a significant association between hyperhomocysteinemia and hyperuricemia. Sex differences were observed. This study suggests that accelerated atherosclerosis may be a consequence of the combined effect of these 2 factors.
背景/目的：高同型半胱氨酸血症和高尿酸血症均被视为冠状动脉疾病的危险因素。然而，二者之间的关系尚未得到充分研究。本研究旨在更深入地评估这种关系。
本研究是一项对以色列某筛查中心16477名年龄在20至80岁之间受试者数据的回顾性横断面分析。
研究样本的平均年龄为46岁，68%为男性。同型半胱氨酸血清水平升高和正常的受试者中，高尿酸血症的发生率分别为24.9%和14.6%（P<0.001）。血清同型半胱氨酸水平与尿酸水平呈正相关。与同型半胱氨酸血清水平正常的受试者相比，高同型半胱氨酸血症患者发生高尿酸血症的优势比（OR）在男性中为1.7（95%置信区间[CI]，1.5 - 1.9），在女性中为1.6（95%CI，1.1 - 2.5）。在对年龄、高血压、体重指数、估计肾小球滤过率、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和噻嗪类药物使用情况进行多变量调整后，这种关联在男性中仍然显著（OR，1.5；95%CI，1.3 - 1.7；P<0.001），但在女性中不显著（OR，0.9；95%CI，0.6 - 1.6；P = 0.82）。
这个大型队列研究表明高同型半胱氨酸血症与高尿酸血症之间存在显著关联。观察到了性别差异。本研究提示动脉粥样硬化加速可能是这两种因素共同作用的结果。
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