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中年女性的血清尿酸水平与11.5年死亡率:芝加哥心脏协会工业检测项目的研究结果

Serum uric acid and 11.5-year mortality of middle-aged women: findings of the Chicago Heart Association Detection Project in Industry.

作者信息

Levine W, Dyer A R, Shekelle R B, Schoenberger J A, Stamler J

机构信息

Department of Community Health and Preventive Medicine, Northwestern University Medical School, Chicago, IL 60611.

出版信息

J Clin Epidemiol. 1989;42(3):257-67. doi: 10.1016/0895-4356(89)90061-9.

Abstract

The relationships of serum uric acid to mortality from all causes, the cardiovascular diseases, and cancer were evaluated in 6797 white women age 35-64 years followed for an average of 11.5 years in the Chicago Heart Association Detection Project in Industry (CHA). Serum uric acid levels at baseline were strongly and significantly associated with all causes mortality in this cohort, with control for multiple risk factors and with exclusion of hypertensives on treatment. When the analysis was performed on age-specific groups 35-44, 45-54, and 55-64 years of age, the association was observed primarily in women in the oldest age group. All cardiovascular deaths, deaths due to coronary heart disease, and all cancer deaths were also associated with serum uric acid levels in the 55-64 year old group. The relationships persisted with control for multiple risk factors and with exclusion of treated hypertensives. A site-specific analysis of cancer deaths demonstrated elevations in mean serum uric acid levels for nearly all sites. Differences in mean serum uric acid levels between decedents and survivors tended to be largest in the first 5 years of follow-up for the cardiovascular deaths, but for cancer decedents they tended to be larger for subsequent years of follow-up. As an initial report on the association of serum uric acid and cancer in women in this age group, the results of this study require confirmation. Although hormonal influences may play a role, pathophysiologic mechanisms relating serum uric acid to mortality in white women aged 55-64 are currently unknown.

摘要

在芝加哥心脏协会工业检测项目(CHA)中,对6797名年龄在35 - 64岁的白人女性进行了平均11.5年的随访,以评估血清尿酸与全因死亡率、心血管疾病死亡率和癌症死亡率之间的关系。在该队列中,对多个风险因素进行控制并排除正在接受治疗的高血压患者后,基线时的血清尿酸水平与全因死亡率密切相关且具有统计学意义。当对35 - 44岁、45 - 54岁和55 - 64岁的特定年龄组进行分析时,这种关联主要在年龄最大的组中的女性中观察到。在55 - 64岁组中,所有心血管死亡、冠心病死亡和所有癌症死亡也都与血清尿酸水平相关。在对多个风险因素进行控制并排除接受治疗的高血压患者后,这种关系依然存在。对癌症死亡进行的特定部位分析表明,几乎所有部位的平均血清尿酸水平都有所升高。心血管死亡患者和存活者之间的平均血清尿酸水平差异在随访的前5年中往往最大,但对于癌症死亡患者,在随后的随访年份中差异往往更大。作为关于该年龄组女性血清尿酸与癌症关联的初步报告,本研究结果需要进一步证实。尽管激素影响可能起作用,但目前尚不清楚血清尿酸与55 - 64岁白人女性死亡率之间的病理生理机制。

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