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日本人群的血清尿酸水平与死亡率:山形(高畑)研究

Serum uric acid levels and mortality in the Japanese population: the Yamagata (Takahata) study.

作者信息

Kamei Keita, Konta Tsuneo, Ichikawa Kazunobu, Sato Hiroko, Suzuki Natsuko, Kabasawa Asami, Suzuki Kazuko, Hirayama Atsushi, Shibata Yoko, Watanabe Tetsu, Kato Takeo, Ueno Yoshiyuki, Kayama Takamasa, Kubota Isao

机构信息

Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine, 2-2-2, Iida-Nishi, Yamagata, 990-9585, Japan.

Global COE, Yamagata University School of Medicine, Yamagata, Japan.

出版信息

Clin Exp Nephrol. 2016 Dec;20(6):904-909. doi: 10.1007/s10157-016-1228-1. Epub 2016 Jan 16.

Abstract

BACKGROUND

Serum uric acid level is regulated by gender, dietary habit, genetic predisposition, and renal function, and is associated with the development of renal and cardiovascular diseases. This study prospectively investigated the association between serum uric acid levels and mortality in a community-based population.

METHODS

Three thousand four hundred and eighty-seven subjects regardless of the antihyperuricemic medication (45 % male; mean age 62 years old) from the Takahata town in Japan participated in this study and were followed up for 8 years (median 7.5 years). We examined the association between serum uric acid levels at baseline and the all-cause and cardiovascular mortality, respectively, in this population.

RESULTS

One hundred seventy-nine subjects died during the follow-up period, with 49 deaths attributed to cardiovascular causes. Kaplan-Meier analysis revealed that the all-cause mortality was significantly higher along with the increase in serum uric acid levels at baseline among female (Log-rank P < 0.01), but not male subjects (P = 0.97). Cox-proportional hazard model analysis with adjustment for possible confounders including age, renal function, and comorbidities revealed that hyperuricemia (uric acid ≥7.0 mg/dL) was an independent risk factor for all-cause and cardiovascular mortality, respectively, in female [hazard ratio (HR) 5.92, 95 % confidence interval (CI) 2.10-14.6 for all-cause mortality, and HR 10.7, 95 % CI 1.76-50.2 for cardiovascular mortality], but not male subjects.

CONCLUSION

Hyperuricemia was an independent risk for all-cause and cardiovascular mortality in female, but not among the male subjects in a community-based population.

摘要

背景

血清尿酸水平受性别、饮食习惯、遗传易感性和肾功能调节,并与肾脏和心血管疾病的发生相关。本研究前瞻性调查了社区人群中血清尿酸水平与死亡率之间的关联。

方法

来自日本高幡城镇的3487名受试者(无论是否服用抗高尿酸血症药物,45%为男性;平均年龄62岁)参与了本研究,并进行了8年的随访(中位随访时间7.5年)。我们分别研究了该人群基线血清尿酸水平与全因死亡率和心血管死亡率之间的关联。

结果

179名受试者在随访期间死亡,其中49例死于心血管疾病。Kaplan-Meier分析显示,女性基线血清尿酸水平升高时全因死亡率显著升高(对数秩检验P<0.01),而男性则无此现象(P = 0.97)。在对年龄、肾功能和合并症等可能的混杂因素进行校正后,Cox比例风险模型分析显示,高尿酸血症(尿酸≥7.0mg/dL)分别是女性全因死亡率和心血管死亡率的独立危险因素[全因死亡率的风险比(HR)为5.92,95%置信区间(CI)为2.10 - 14.6;心血管死亡率的HR为10.7,95%CI为1.76 - 50.2],但在男性受试者中并非如此。

结论

在社区人群中,高尿酸血症是女性全因死亡率和心血管死亡率的独立危险因素,但在男性中并非如此。

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