儿童血浆尿酸和嘌呤代谢产物与血压的关联：考拉出生队列研究

Associations of plasma uric acid and purine metabolites with blood pressure in children: the KOALA Birth Cohort Study.

作者信息

Scheepers Lieke E J M, Boonen Annelies, Pijnenburg Wieke, Bierau Jörgen, Staessen Jan A, Stehouwer Coen D A, Thijs Carel, Arts Ilja C W

机构信息

aDivision of Rheumatology, Department of Internal Medicine, Maastricht University Medical CentrebCAPHRI School for Public Health and Primary CarecDepartment of Epidemiology, Maastricht UniversitydDepartment of Clinical Genetics, Maastricht University Medical Centre, Maastricht, The NetherlandseResearch Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Diseases, Studies Coordinating Centre, University of Leuven, Leuven, BelgiumfDepartment of Internal Medicine, Maasticht University Medical CentergCARIM School for Cardiovascular Diseases, Maastricht University Medical CentrehCARIM School for Cardiovascular Diseases, and MaCSBio Maastricht Centre for Systems Biology, Maastricht University, Maastricht, The Netherlands.

出版信息

J Hypertens. 2017 May;35(5):982-993. doi: 10.1097/HJH.0000000000001270.

DOI:10.1097/HJH.0000000000001270

PMID:28355168

Abstract

OBJECTIVE

Elevated serum uric acid concentration has been associated with high blood pressure (BP) and hypertension. A putative underlying mechanism is the accumulation of reactive oxygen species when uric acid is generated by an increased enzyme activity of xanthine oxidase (XO). The aims of the present study were to investigate the associations between plasma uric acid concentration, purine metabolite ratios, as proxies for increased XO activity, and SBP and DBP in school-age children.

METHODS

Cross-sectional analyses were performed in 246 children (46% boys; mean age 7.1 years) from the Dutch KOALA Birth Cohort Study. Purine metabolites were determined with ultra-performance liquid chromatography-tandem mass spectrometry. During a home visit, a nurse collected a blood sample and measured BP three times; in addition, parents measured their child's BP on three consecutive days, in the morning and evening. Generalized estimating equations were used for analyses while controlling for variables such as sex, age, BMI, physical activity, and dietary intake.

RESULTS

In multivariable analysis, uric acid (per SD of 38 μmol/l) was associated with DBP z-scores [sβ 0.07; confidence interval (CI), 0.01-1.14], but not with SBP z-scores. Higher ratios of uric acid/xanthine (per SD of 138) (sβ 0.09; CI, 0.01-0.17) and xanthine/hypoxanthine (per SD of 321) (sβ 0.08; CI, 0.02-0.17) were associated with higher DBP z-scores, but not with SBP z-scores.

CONCLUSION

In school-age children, uric acid and the ratios of uric acid/xanthine and xanthine/hypoxanthine were significantly associated with DBP z-scores. Suggesting that, both uric acid concentration and increased XO activity are associated with BP.

摘要

目的

血清尿酸浓度升高与高血压相关。一种可能的潜在机制是当黄嘌呤氧化酶（XO）的酶活性增加导致尿酸生成时，活性氧的积累。本研究的目的是调查学龄儿童血浆尿酸浓度、嘌呤代谢物比率（作为XO活性增加的指标）与收缩压（SBP）和舒张压（DBP）之间的关联。

方法

对来自荷兰考拉出生队列研究的246名儿童（46%为男孩；平均年龄7.1岁）进行横断面分析。用超高效液相色谱 - 串联质谱法测定嘌呤代谢物。在一次家访中，护士采集血样并测量血压三次；此外，家长在连续三天的早晚测量孩子的血压。在控制性别、年龄、体重指数、身体活动和饮食摄入等变量的同时，使用广义估计方程进行分析。

结果

在多变量分析中，尿酸（每标准差38μmol/l）与DBP z评分相关[sβ 0.07；置信区间（CI），0.01 - 1.14]，但与SBP z评分无关。尿酸/黄嘌呤比率较高（每标准差138）（sβ 0.09；CI，0.01 - 0.17）和黄嘌呤/次黄嘌呤比率较高（每标准差321）（sβ 0.08；CI，0.02 - 0.17）与较高的DBP z评分相关，但与SBP z评分无关。