Wu I-H, Wu J-S, Sun Z-J, Lu F-H, Chang C-S, Chang C-J, Yang Y-C
Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, ROC.
Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan, ROC.
J Hum Hypertens. 2016 Aug;30(8):479-82. doi: 10.1038/jhh.2016.4. Epub 2016 Feb 25.
Although the association between serum uric acid (SUA) levels and prehypertension has been reported in previous studies, it is unknown whether their relationship is similar in subjects with diabetes, pre-diabetes and normal glucose tolerance (NGT). This study thus aimed to investigate the relationship between SUA and prehypertension in subjects with different glycemic status, including NGT, pre-diabetes and diabetes. A total of 12 010 participants were included after excluding subjects with blood pressure ⩾140/90 mm Hg, history of hypertension, leukaemia, lymphoma, hypothyroidism, medication for hypertension and hyperuricemia and missing data. Subjects were divided into four groups based on SUA quartiles (male Q1: ⩽345.0, Q2: 345.0-392.6, Q3: 392.6-440.2, Q4: ⩾440.2 μmol l(-1) and female Q1: ⩽249.8, Q2: 249.8-285.5, Q3: 285.5-333.1, Q4: ⩾333.1 μmol l(-1)). Diabetes, pre-diabetes and NGT were assessed according to the 2010 American Diabetes Association diagnostic criteria. Normotension and prehypertension were defined according to the JNC-7 (The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure) criteria. The SUA was significantly higher in prehypertensive subjects as compared with normotensive subjects. SUA, as a continuous variable, was positively associated with prehypertension in subjects with NGT but not pre-diabetes and diabetes. Besides, NGT subjects with the highest quartile of SUA exhibited a higher risk of prehypertension after adjustment for other confounding factors. In pre-diabetes and diabetes groups, none of SUA quartiles was significantly related to prehypertension. SUA was significantly associated with an increased risk of prehypertension in subjects with NGT but insignificantly in subjects with pre-diabetes and diabetes.
尽管既往研究已报道血清尿酸(SUA)水平与高血压前期之间存在关联,但在糖尿病、糖尿病前期和糖耐量正常(NGT)的受试者中,它们之间的关系是否相似尚不清楚。因此,本研究旨在调查不同血糖状态(包括NGT、糖尿病前期和糖尿病)的受试者中SUA与高血压前期之间的关系。在排除血压≥140/90 mmHg、有高血压病史、白血病、淋巴瘤、甲状腺功能减退、正在服用抗高血压和高尿酸血症药物以及有缺失数据的受试者后,共纳入了12010名参与者。根据SUA四分位数将受试者分为四组(男性Q1:≤345.0,Q2:345.0 - 392.6,Q3:392.6 - 440.2,Q4:≥440.2 μmol l⁻¹;女性Q1:≤249.8,Q2:249.8 - 285.5,Q3:285.5 - 333.1,Q4:≥333.1 μmol l⁻¹)。根据2010年美国糖尿病协会诊断标准评估糖尿病、糖尿病前期和NGT。根据美国预防、检测、评估与治疗高血压联合委员会第七次报告(JNC - 7)标准定义正常血压和高血压前期。与血压正常的受试者相比,高血压前期受试者的SUA显著更高。作为连续变量,SUA与NGT受试者的高血压前期呈正相关,但与糖尿病前期和糖尿病受试者无关。此外,在调整其他混杂因素后,SUA处于最高四分位数的NGT受试者发生高血压前期的风险更高。在糖尿病前期和糖尿病组中,SUA的任何四分位数均与高血压前期无显著相关性。SUA与NGT受试者高血压前期风险增加显著相关,但与糖尿病前期和糖尿病受试者无关。