Guo Xiaofan, Li Zhao, Liu Yamin, Yu Shasha, Yang Hongmei, Zheng Liqiang, Zhang Yonghong, Sun Yingxian
Department of Cardiology, the First Hospital of China Medical University, Shenyang, Liaoning Department of Cardiology, Johns Hopkins University, Baltimore, Maryland, US Department of Clinical Epidemiology, Library, Shengjing Hospital of China Medical University, Shenyang, Liaoning Department of Epidemiology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China.
Medicine (Baltimore). 2016 Dec;95(50):e5568. doi: 10.1097/MD.0000000000005568.
Recently, it has been found that high level of serum uric acid (SUA) is causally related to sudden cardiac death (SCD). We examined the sex-specific associations of SUA with prolonged heart rate-corrected QT (QTc) interval in a general Chinese population.A large sample of 11,206 Chinese research participants aged 35 years and older was recruited from rural areas of Liaoning Province during 2012 to 2013. SUA were divided into quartiles separated for males and females. Prolonged QTc interval, assessed by the Bazett formula, was defined as cut points of 460 ms or longer in females and 450 ms or longer in males. Mean (+/- standard deviation) QTc intervals were 422.1 ± 24.2 ms among 5104 males and 436.1 ± 23.5 ms among 6102 females, respectively. In both sexes, SUA showed significant correlations with QTc interval (both P < 0.001). Among male participants, the highest quartile of SUA (>379 μmol/L) was related to an increased risk for prolonged QTc interval (odds ratios: 1.402, 95% confidence interval: 1.073-1.831) compared to the lowest quartile (≤276 μmol/L) after fully adjustment. However, there were no significant relationships between SUA and prolonged QTc interval among females in all the models.Males with high SUA are prone to a higher risk for prolonged QTc interval. This study provides novel explanation for population-based findings on SUA and SCD, as well as important implications for management strategies for hyperuricemic patients in clinical practice.
最近，人们发现血清尿酸（SUA）水平升高与心源性猝死（SCD）存在因果关系。我们在中国普通人群中研究了SUA与心率校正QT（QTc）间期延长的性别特异性关联。2012年至2013年期间，从辽宁省农村地区招募了11206名35岁及以上的中国研究参与者作为大样本。SUA按男性和女性分别分为四分位数。通过Bazett公式评估的QTc间期延长定义为女性切点为460毫秒或更长，男性切点为450毫秒或更长。5104名男性的平均（±标准差）QTc间期为422.1±24.2毫秒，6102名女性的平均QTc间期为436.1±23.5毫秒。在两性中，SUA均与QTc间期显著相关（P均<0.001）。在男性参与者中，与最低四分位数（≤276μmol/L）相比，SUA最高四分位数（>379μmol/L）在完全调整后与QTc间期延长风险增加相关（优势比：1.402，95%置信区间：1.073 - 1.831）。然而，在所有模型中，女性的SUA与QTc间期延长之间均无显著关系。SUA水平高的男性更容易出现QTc间期延长的风险。本研究为基于人群的SUA与SCD研究结果提供了新的解释，也为临床实践中高尿酸血症患者的管理策略提供了重要启示。
