Kuwabara Masanari, Niwa Koichiro, Hisatome Ichiro, Nakagawa Takahiko, Roncal-Jimenez Carlos A, Andres-Hernando Ana, Bjornstad Petter, Jensen Thomas, Sato Yuka, Milagres Tamara, Garcia Gabriela, Ohno Minoru, Lanaspa Miguel A, Johnson Richard J
From the Division of Renal Diseases and Hypertension, School of Medicine, University of Colorado Denver, Aurora (M.K., C.A.R.-J., A.A.-H., P.B., T.J., Y.S., T.M., G.G., M.A.L., R.J.J.); Department of Cardiology, Toranomon Hospital, Tokyo, Japan (M.K., M.O.); Cardiovascular Center, St Luke's International Hospital, Tokyo, Japan (M.K., K.N.); Division of Regenerative Medicine and Therapeutics, Tottori University Graduate School of Medical Sciences, Yonago, Japan (I.H.); Future Basic Medicine, Nara Medical University, Kashihara, Japan (T.N.); and Children's Hospital Colorado and Barbara Davis Center for Childhood Diabetes, Aurora (P.B.).
Hypertension. 2017 Jun;69(6):1036-1044. doi: 10.1161/HYPERTENSIONAHA.116.08998. Epub 2017 Apr 10.
Whether asymptomatic hyperuricemia in the absence of comorbidities increases the risk for cardiometabolic disorders and chronic kidney disease remains controversial. This study was conducted to clarify the association between asymptomatic hyperuricemia and cardiometabolic conditions. Subjects consisting of Japanese adults between 30 and 85 years of age were enrolled in the study at Center for Preventive Medicine, St Luke's International Hospital, Tokyo, and were available at enrollment (2004) and at 5-year follow-up (2009). Subjects were excluded if they were overweight or obese, hypertensive, diabetic, and dyslipidemic, had a history of gout or hyperuricemia on medications, or had chronic kidney disease as estimated glomerular filtration rate <60 mL/min per 1.73 m Linear and logistic regression analyses were used to examine the relationship between hyperuricemia and development of hypertension, diabetes mellitus, dyslipidemia, chronic kidney disease, and overweight/obesity (unadjusted and adjusted for age, sex, smoking, drinking habits, baseline estimated glomerular filtration rate, and body mass index). Five thousand eight hundred and ninety-nine subjects without comorbidities (mean age of 47±10 years, 1864 men) were followed for 5 years. Hyperuricemia (defined as >7 mg/dL in men and ≥6 mg/dL in women) was associated with increased cumulative incidence of hypertension (14.9% versus 6.1%; <0.001), dyslipidemia (23.1% versus 15.5%; <0.001), chronic kidney disease (19.0% versus 10.7%; <0.001), and overweight/obesity (8.9% versus 3.0%; <0.001), while diabetes mellitus (1.7% versus 0.9%; =0.087) showed a trend but did not reach statistical significance. In conclusion, asymptomatic hyperuricemia carries a significant risk for developing cardiometabolic conditions in Japanese individual without comorbidities.
在无合并症的情况下,无症状高尿酸血症是否会增加发生心脏代谢紊乱和慢性肾脏病的风险仍存在争议。本研究旨在阐明无症状高尿酸血症与心脏代谢状况之间的关联。研究对象为年龄在30至85岁之间的日本成年人,他们在东京圣路加国际医院预防医学中心入组研究,且在入组时(2004年)和5年随访时(2009年)均可用。如果受试者超重或肥胖、患有高血压、糖尿病、血脂异常、有痛风病史或正在服用治疗高尿酸血症的药物,或患有慢性肾脏病且估算肾小球滤过率<60 mL/min per 1.73 m²,则将其排除。采用线性和逻辑回归分析来检验高尿酸血症与高血压、糖尿病、血脂异常、慢性肾脏病以及超重/肥胖发生之间的关系(未调整以及根据年龄、性别、吸烟、饮酒习惯、基线估算肾小球滤过率和体重指数进行调整)。对5899名无合并症的受试者(平均年龄47±10岁,男性1864名)进行了5年随访。高尿酸血症(男性定义为>7 mg/dL,女性定义为≥6 mg/dL)与高血压累积发病率增加(14.9%对6.1%;<0.001)、血脂异常(23.1%对15.5%;<0.001)、慢性肾脏病(19.0%对10.7%;<0.001)以及超重/肥胖(8.9%对3.0%;<0.001)相关,而糖尿病(1.7%对0.9%;=0.087)虽有趋势但未达到统计学显著性。总之,在无合并症的日本个体中,无症状高尿酸血症具有发生心脏代谢疾病的显著风险。