Chen Xuling, Meng Ying, Li Jun, She Hiacheng, Zhao Liang, Zhang Jing, Peng Yuan, Shang Kun, Zhang Yadi, Gu Xiaopeng, Yang Wenbin, Zhang Yan, Li Jianping, Qin Xianhui, Wang Binyan, Xu Xiping, Hou Fanfan, Tang Genfu, Liao Rongfeng, Huo Yong, Yang Liu
Department of Ophthalmology, Key Laboratory of Vision Loss and Restoration, Ministry of Education, Peking University First Hospital, No.8 Xishiku Street, Xicheng District, Beijing, 100034, China.
Department of Tongren Hospital, Beijing, 100005, China.
BMC Ophthalmol. 2017 Jun 2;17(1):83. doi: 10.1186/s12886-017-0470-y.
This cross sectional investigation included 12,966 subjects with hypertension, a cohort of the China Stroke Primary Prevention Trial (CSPPT), a randomized, multicenter clinical trial. This study aimed to explore the correlation between serum uric acid (SUA) concentration and hypertensive retinopathy in hypertensive adults.
Diagnosis of hypertensive retinopathy was determined by non-mydriatic fundus photography and classified with Keith-Wagener-Barker (KWB) system. The correlation of SUA levels with hypertensive retinopathy prevalence and severity was assessed by statistical analysis.
9848 (75.95%) subjects were diagnosed with hypertensive retinopathy with the following retinopathy grade distribution: grade 1: 58.80%, grade 2: 14.81%, and grade 3-4: 2.34%. SUA levels were significantly associated with hypertensive retinopathy prevalence. Patients with hypertensive retinopathy had higher SUA levels than those without hypertensive retinopathy. Patients in the highest uric acid quartile had an odds ratio for hypertensive retinopathy of 1.21 compared to patients in the lowest uric acid quartile (OR = 1.21, 95% CI: 1.05-1.40, P = 0.008). When compared to the non-hyperuricemia group, those in the hyperuricemia group had an odds ratio for hypertensive retinopathy of 1.18(OR = 1.18, 95% CI: 1.05-1.33, P = 0.004). Every 1 mg/dl increase in uric acid concentration was significantly associated with a 6% higher odds of hypertensive retinopathy (OR = 1.06, 95% CI: 1.02-1.10, P = 0.002).
The prevalence of hypertensive retinopathy was high (75.95%) among hypertensives in our patients cohort. In addition, SUA concentration was significantly associated with hypertensive retinopathy.
这项横断面调查纳入了12966名高血压患者,他们是中国脑卒中一级预防试验(CSPPT)这一随机、多中心临床试验中的一个队列。本研究旨在探讨高血压成年患者血清尿酸(SUA)浓度与高血压视网膜病变之间的相关性。
通过免散瞳眼底照相诊断高血压视网膜病变,并采用Keith-Wagener-Barker(KWB)系统进行分级。通过统计分析评估SUA水平与高血压视网膜病变患病率及严重程度之间的相关性。
9848名(75.95%)受试者被诊断为高血压视网膜病变,其视网膜病变分级分布如下:1级:58.80%,2级:14.81%,3 - 4级:2.34%。SUA水平与高血压视网膜病变患病率显著相关。患有高血压视网膜病变的患者SUA水平高于未患高血压视网膜病变的患者。尿酸水平处于最高四分位数的患者患高血压视网膜病变的比值比为1.21,而尿酸水平处于最低四分位数的患者为1(比值比 = 1.21,95%置信区间:1.05 - 1.40,P = 0.008)。与非高尿酸血症组相比,高尿酸血症组患高血压视网膜病变的比值比为1.18(比值比 = 1.18,95%置信区间:1.05 - 1.33,P = 0.004)。尿酸浓度每升高1mg/dl,患高血压视网膜病变的几率显著增加6%(比值比 = 1.06,95%置信区间:1.02 - 1.10,P = 0.002)。
在我们的患者队列中,高血压患者的高血压视网膜病变患病率较高(75.95%)。此外,SUA浓度与高血压视网膜病变显著相关。