Lambert Elisabeth A, Hachem Mariam, Hemmes Robyn, Straznicky Nora E, Eikelis Nina, Sari Carolina I, Schlaich Markus P, Lambert Gavin W, Dixon John B
aHuman Neurotransmitters Laboratory, Baker IDI Heart & Diabetes Institute bDepartment of Physiology, Monash University, Melbourne, Victoria cRoyal Perth Hospital Unit, School of Medicine and Pharmacology, Perth, Western Australia dFaculty of Medicine, Nursing and Health Sciences eDepartment of General Practice, Monash University, Melbourne, Victoria, Australia.
J Hypertens. 2017 Apr;35(4):745-752. doi: 10.1097/HJH.0000000000001212.
Elevated serum uric acid (SUA) is often present in conditions associated with increased cardiovascular risk yet it is not recognized as a marker of risk. We evaluated whether SUA was associated with evidence of early markers of cardiovascular risk factor including subclinical early organ damage, sympathetic tone and metabolic profile in a healthy population with a high prevalence of obesity.
Data from 281 patients (175 women and 106 men, mean age: 35.5 ± 0.8 years, mean BMI: 33.2 ± 0.5 kg/m) were retrieved from a database. All participants were healthy, nonsmoker and free of medication. Available data included metabolic profile, muscle sympathetic nervous activity (MSNA, microneurography), endothelial function (pulse amplitude tonometry, augmentation index), estimated glomerular filtration rate (eGFR) and echocardiography.
With participants grouped into sex-adjusted tertiles of SUA, those in the third tertile of SUA had increased waist circumference, worse metabolic profile (fasting glucose, total cholesterol, triglycerides and HDL), elevated MSNA, decreased endothelial function, increased augmentation index and decreased eGFR compared with those in the first tertile of SUA. In multiple regression analysis adjusted for age, sex, BMI and ethnicity, SUA was independently associated with waist circumference, low-density lipoprotein, triglycerides, augmentation index, MSNA and eGFR, providing a combined adjusted R = 0.599 or 60% of the overall variance.
In a healthy population with a high proportion of obesity, SUA is associated with measures of metabolic, end-organ damage and sympathetic tone indicating the potential value of SUA as a marker of early cardiovascular disease development.
血清尿酸(SUA)升高常见于心血管风险增加的情况,但它尚未被视为一种风险标志物。我们评估了在肥胖患病率较高的健康人群中,SUA是否与心血管危险因素早期标志物的证据相关,这些标志物包括亚临床早期器官损伤、交感神经张力和代谢谱。
从数据库中检索了281例患者(175例女性和106例男性,平均年龄:35.5±0.8岁,平均BMI:33.2±0.5kg/m)的数据。所有参与者均健康、不吸烟且未服用药物。可用数据包括代谢谱、肌肉交感神经活动(MSNA,微神经ography)、内皮功能(脉搏振幅张力测量法,增强指数)、估计肾小球滤过率(eGFR)和超声心动图。
将参与者按性别调整后的SUA三分位数分组,与SUA第一三分位数的参与者相比,SUA第三三分位数的参与者腰围增加、代谢谱更差(空腹血糖、总胆固醇、甘油三酯和高密度脂蛋白)、MSNA升高、内皮功能降低、增强指数增加且eGFR降低。在对年龄、性别、BMI和种族进行调整的多元回归分析中,SUA与腰围、低密度脂蛋白、甘油三酯、增强指数、MSNA和eGFR独立相关,综合调整后的R = 0.599或占总方差的60%。
在肥胖比例较高的健康人群中,SUA与代谢、终末器官损伤和交感神经张力的测量指标相关,表明SUA作为早期心血管疾病发展标志物的潜在价值。