Department of Community Medicine, Ehime University Graduate School of Medicine, Shitsukawa, Toon-city, Ehime, 791-0295, Japan.
Department of Internal Medicine, Seiyo Municipal Nomura Hospital, 9-53 Nomura, Nomura-cho, Seiyo-city, Ehime, 797-1212, Japan.
J Endocrinol Invest. 2018 Aug;41(8):959-968. doi: 10.1007/s40618-017-0822-8. Epub 2018 Feb 19.
Metabolic syndrome (MetS) is associated with an increased risk of major cardiovascular events. In women, increased serum uric acid (SUA) levels are associated with MetS and its components. However, whether baseline and changes in SUA predict incidence of MetS and its components remains unclear.
The subjects comprised 407 women aged 71 ± 8 years from a rural village. We have identified participants who underwent a similar examination 11 years ago, and examined the relationship between baseline and changes in SUA, and MetS based on the modified criteria of the National Cholesterol Education Program's Adult Treatment Panel (NCEP-ATP) III report.
Of these subjects, 83 (20.4%) women at baseline and 190 (46.7%) women at follow-up had MetS. Multiple linear regression analysis was performed to evaluate the contribution of each confounding factor for MetS; both baseline and changes in SUA as well as history of cardiovascular disease, low-density lipoprotein cholesterol, and estimated glomerular filtration ratio (eGFR) were independently and significantly associated with the number of MetS components during an 11-year follow-up. The adjusted odds ratios (ORs) (95% confidence interval) for incident MetS across tertiles of baseline SUA and changes in SUA were 1.00, 1.47 (0.82-2.65), and 3.11 (1.66-5.83), and 1.00, 1.88 (1.03-3.40), and 2.49 (1.38-4.47), respectively. In addition, the combined effect between increased baseline and changes in SUA was also a significant and independent determinant for the accumulation of MetS components (F = 20.29, p < 0.001). The ORs for incident MetS were significant only in subjects with age ≥ 55 years, decline in eGFR, and no baseline MetS.
These results suggested that combined assessment of baseline and changes in SUA levels provides increased information for incident MetS, independent of other confounding factors in community-dwelling women.
代谢综合征（MetS）与主要心血管事件的风险增加有关。在女性中，血清尿酸（SUA）水平升高与 MetS 及其成分有关。然而，SUA 的基线和变化是否预测 MetS 及其成分的发生尚不清楚。
研究对象为来自农村的 407 名年龄为 71±8 岁的女性。我们确定了 11 年前接受过类似检查的参与者，并根据国家胆固醇教育计划成人治疗专家组（NCEP-ATP）III 报告的修改标准，检查了 SUA 的基线和变化与 MetS 之间的关系。
这些受试者中，83 名（20.4%）女性在基线时和 190 名（46.7%）女性在随访时有 MetS。进行了多元线性回归分析，以评估每个混杂因素对 MetS 的贡献；SUA 的基线和变化以及心血管疾病史、低密度脂蛋白胆固醇和估算肾小球滤过率（eGFR）均与 11 年随访期间 MetS 成分的数量独立且显著相关。SUA 基线和变化的三分位与 MetS 发生率的调整比值比（OR）（95%置信区间）分别为 1.00、1.47（0.82-2.65）和 3.11（1.66-5.83），以及 1.00、1.88（1.03-3.40）和 2.49（1.38-4.47）。此外，基线升高和 SUA 变化之间的联合效应也是 MetS 成分积累的一个显著且独立的决定因素（F=20.29，p<0.001）。仅在年龄≥55 岁、eGFR 下降且无基线 MetS 的患者中，OR 才有统计学意义。
这些结果表明，联合评估 SUA 水平的基线和变化为社区居住女性发生 MetS 提供了更多信息，独立于其他混杂因素。
