Yokoyama Akira, Yokoyama Tetsuji, Mizukami Takeshi, Matsui Toshifumi, Kimura Mitsuru, Matsushita Sachio, Higuchi Susumu, Maruyama Katsuya
National Hospital Organization Kurihama Medical and Addiction Center, Kanagawa 239-0841, Japan
Department of Health Promotion, National Institute of Public Health, Saitama 351-0104, Japan.
Alcohol Alcohol. 2016 May;51(3):268-74. doi: 10.1093/alcalc/agv123. Epub 2015 Nov 4.
To identify determinants of hyperuricemia in alcoholics.
The serum uric acid (UA) levels of 1759 Japanese alcoholic men (≥40 years) were measured on their first visit or within 3 days after admission; ADH1B and ALDH2 genotyping on blood DNA samples were performed. Dipstick urinalyses for ketonuria and serum UA measurements were simultaneously performed for 621 men on their first visit.
Serum UA levels of >416 μmol/l (7.0 mg/dl) and ≥535 μmol/l (9.0 mg/dl) were observed in 30.4 and 7.8% of the subjects, respectively. Ketonuria was positive in 35.9% of the subjects, and a multivariate analysis revealed that the ketosis level was positively associated with the UA level. The presence of the ADH1B2 allele and the ALDH21/1 genotype increased the odds ratio (OR; 95% confidence interval) among subjects with a high UA level of >416 μmol/l (vs. ≤416 μmol/l; 2.04 [1.58-2.65] and 1.48 [1.09-2.01], respectively) and those with a high UA level of ≥535 μmol/l (vs. ≤416 μmol/l; 2.29 [1.42-3.71] and 3.03 [1.51-6.08], respectively). The ADH1B2 plus ALDH2*1/1 combination yielded the highest ORs (2.86 [1.61-5.10] and 6.21 [1.49-25.88] for a UA level of >416 μmol/l and ≥535 μmol/l, respectively), compared with the ADH1B1/1 plus ALDH21/*2 combination. The presence of diabetes and the consumption of Japanese sake rather than beer were negatively associated with the UA levels.
The faster metabolism of ethanol and acetaldehyde by the ADH1B2 allele and ALDH21/*1 genotype and higher ketosis levels were associated with higher UA levels in alcoholics, while diabetes and the consumption of sake were negative determinants.
确定酗酒者高尿酸血症的决定因素。
对1759名日本男性酗酒者(≥40岁)首次就诊时或入院后3天内测量血清尿酸(UA)水平;对血液DNA样本进行ADH1B和ALDH2基因分型。621名男性首次就诊时同时进行尿酮体试纸分析和血清UA测量。
分别有30.4%和7.8%的受试者血清UA水平>416μmol/l(7.0mg/dl)和≥535μmol/l(9.0mg/dl)。35.9%的受试者尿酮体呈阳性,多因素分析显示酮血症水平与UA水平呈正相关。ADH1B2等位基因和ALDH21/1基因型的存在增加了UA水平>416μmol/l(与≤416μmol/l相比;优势比[OR]分别为2.04[1.58 - 2.65]和1.48[1.09 - 2.01])以及UA水平≥535μmol/l(与≤416μmol/l相比;OR分别为2.29[1.42 - 3.71]和3.03[1.51 - 6.08])的受试者的优势比。与ADH1B1/1加ALDH21/2组合相比,ADH1B2加ALDH2*1/*1组合产生的OR最高(UA水平>416μmol/l和≥535μmol/l时分别为2.86[1.61 - 5.10]和6.21[1.49 - 25.8])。糖尿病的存在以及饮用日本清酒而非啤酒与UA水平呈负相关。
ADH1B2等位基因和ALDH21/*1基因型使乙醇和乙醛代谢加快以及较高的酮血症水平与酗酒者较高的UA水平相关,而糖尿病和清酒饮用则是负向决定因素。