Department of Internal Medicine, Tri-Service General Hospital Songshan Branch, Taiwan, Republic of China; Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.
Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China; Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China; Graduate Institute of Clinical Medical, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China.
Clin Chim Acta. 2018 Mar;478:68-73. doi: 10.1016/j.cca.2017.12.038. Epub 2017 Dec 24.
A growing number of studies are available to shed some light on the association between uric acid (UA) and cardiovascular diseases. However, there have been few studies to support a causal link between UA, metabolic syndrome (MetS), diabetes mellitus (DM) and hypertension (HTN) in young subjects.
From the Health Examination Registration System of Taiwanese military service during the period 2013-2015, there were 46,561 eligible participants who were 20years old or older in our study. Different analytical steps of analysis were performed to examine the association between UA and cardiometabolic risk using logistic regression, receiver operating characteristic (ROC) curve analysis and Cox regression.
For total population, serum UA had significant associations with the presence of MetS (OR=2.08, 95% CI=1.51-2.87), DM (OR=2.59, 95% CI=1.09-6.19) and HTN (OR=1.49, 95% CI=1.07-2.07) in the cross-sectional analysis. According to the cut-off values of UA calculating by the ROC curve analysis in each sex/age subgroup, the association between UA and incident adverse outcomes were analyzed in a longitudinal study. In male, higher UA significantly increased the risks for developing MetS in 30-40years (HR=1.12, 95% CI=1.01-1.25), DM in <30years (HR=2.75, 95% CI=1.38-5.45) and HTN in all subgroups (HR=1.17, 95% CI=1.01-1.37; HR=1.65, 95% CI=1.08-2.53; HR=1.72, 95% CI=1.22-2.43). In females, a higher UA was significantly associated with an increased risk of incident MetS in >40years (HR=2.99, 95% CI=1.34-6.64), HTN in >40years (HR=2.58, 95% CI=1.02-6.55), and no increased risk of DM.
Our study concluded that serum UA is an important predictor for the risk of incident MetS, DM, and HTN in adults, especially in male population.
越来越多的研究表明尿酸（UA）与心血管疾病之间存在关联。然而，关于 UA、代谢综合征（MetS）、糖尿病（DM）和高血压（HTN）在年轻人群中是否存在因果关系，目前还缺乏相关研究。
本研究从 2013 年至 2015 年台湾兵役健康检查登记系统中选取了 46561 名年龄在 20 岁及以上的符合条件的参与者。采用逻辑回归、受试者工作特征（ROC）曲线分析和 Cox 回归等不同分析步骤，检查 UA 与心血管代谢风险之间的关系。
在横断面分析中，对于全人群，血清 UA 与 MetS（OR=2.08，95%CI=1.51-2.87）、DM（OR=2.59，95%CI=1.09-6.19）和 HTN（OR=1.49，95%CI=1.07-2.07）的存在显著相关。根据 ROC 曲线分析在每个性别/年龄亚组中计算的 UA 截断值，在纵向研究中分析 UA 与新发不良结局之间的关系。在男性中，较高的 UA 显著增加了 30-40 岁发生 MetS（HR=1.12，95%CI=1.01-1.25）、<30 岁发生 DM（HR=2.75，95%CI=1.38-5.45）和所有亚组发生 HTN（HR=1.17，95%CI=1.01-1.37；HR=1.65，95%CI=1.08-2.53；HR=1.72，95%CI=1.22-2.43）的风险。在女性中，较高的 UA 与>40 岁发生 MetS（HR=2.99，95%CI=1.34-6.64）、>40 岁发生 HTN（HR=2.58，95%CI=1.02-6.55）的风险增加显著相关，而与 DM 的风险增加无关。
本研究表明，血清 UA 是成年人发生 MetS、DM 和 HTN 的重要预测指标，特别是在男性人群中。
