Alegría-Díaz Araceli, Valdez-Ortiz Rafael, Murguía-Romero Miguel, Jiménez-Flores Rafael, Villalobos-Molina Rafael, Mummidi Srinivas, Duggirala Ravindranth, López-Alvarenga Juan C, Pérez-Navarro Monserrat
Contrib Nephrol. 2018;192:125-134. doi: 10.1159/000484287. Epub 2018 Jan 23.
High serum uric acid concentration (SUA >6 for women [W] or 7 mg/dL for men [M]) in adults is an independent risk factor for causing cardiovascular disease and chronic kidney disease (CKD); the risk of high SUA in young population is still being debated.
We conducted an epidemiological study to determine the association between SUA quartiles with cardiometabolic risk factors (CRF) and renal impairment in apparently healthy young adults. CRF (dyslipidemia, overweight [Ow], obesity [Ob], blood pressure [BP], hyperglycemia, insulin resistance [IR]) and renal impairment were defined as glomerular filtration rate (GFR) by CKD-Epidemiology Collaboration formula >130/120, <90 mL/min/1.73 m2, and proteinuria were measured in 18- to 25-year-old students (total n = 5,531). Adjusted ORs by sex were calculated using logistic regression.
The mean SUA was 4.5 ± 1.04 and 6.2 ± 1.2 mg/dL in W and M respectively. High SUA was found in 13.9% (n = 767); prevalence of Ow/Ob 69% (528 of 767), high BP 9% (67), hyperglycemia 15% (112), IR 47% (214), hypertriglyceridemia 35% (269), high LDL-c 16% (120), low HDL-c 52% (399), and metabolic syndrome 33% (249). Prevalence of high GFR was 13% (103), low GFR 8% (62) and proteinuria 5% (37). All risk factors showed a positive relationship with the SUA quartiles with high LDL-c with lowest risk (OR 1.7) and Ow/Ob with highest risk (OR 4.1), independent of sex. Key Messages: High SUA concentrations (M ≥6.2/W ≥4.5 mg/dL) are associated with CRF and renal impairment in young adults. It is necessary to reevaluate the cutoff points for UA in young adults.
成人高血清尿酸浓度(女性[W]血清尿酸>6mg/dL,男性[M]血清尿酸>7mg/dL)是导致心血管疾病和慢性肾脏病(CKD)的独立危险因素;年轻人群高血清尿酸的风险仍存在争议。
我们开展了一项流行病学研究,以确定血清尿酸四分位数与明显健康的年轻成年人中心血管代谢危险因素(CRF)及肾功能损害之间的关联。心血管代谢危险因素(血脂异常、超重[Ow]、肥胖[Ob]、血压[BP]、高血糖、胰岛素抵抗[IR])及肾功能损害定义为采用CKD-Epidemiology协作组公式计算的肾小球滤过率(GFR)>130/120、<90mL/min/1.73m²,对18至25岁的学生(共n=5531)检测蛋白尿。采用logistic回归按性别计算校正后的比值比(OR)。
女性和男性的平均血清尿酸分别为4.5±1.04mg/dL和6.2±1.2mg/dL。发现高血清尿酸者占13.9%(n=767);超重/肥胖患病率为69%(767例中的528例),高血压患病率为9%(67例),高血糖患病率为15%(112例),胰岛素抵抗患病率为47%(214例),高甘油三酯血症患病率为35%(269例),高LDL-C患病率为16%(120例),低HDL-C患病率为52%(399例),代谢综合征患病率为33%(249例)。高GFR患病率为13%(103例),低GFR患病率为8%(62例),蛋白尿患病率为5%(37例)。所有危险因素均与血清尿酸四分位数呈正相关,其中高LDL-C风险最低(OR 1.7),超重/肥胖风险最高(OR 4.1),且不受性别影响。关键信息:高血清尿酸浓度(男性≥6.2mg/dL/女性≥4.5mg/dL)与年轻成年人的心血管代谢危险因素及肾功能损害相关。有必要重新评估年轻成年人尿酸的临界值。