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血清尿酸水平升高可预测中度冠状动脉钙化的发生,而与传统心血管危险因素无关。

Elevated serum uric acid predicts the development of moderate coronary artery calcification independent of conventional cardiovascular risk factors.

机构信息

Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul 135-710, Republic of Korea.

Department of Health Promotion Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul 135-710, Republic of Korea.

出版信息

Atherosclerosis. 2018 May;272:233-239. doi: 10.1016/j.atherosclerosis.2018.02.014. Epub 2018 Feb 14.

Abstract

BACKGROUND AND AIMS

Hyperuricemia was frequently noted in subjects with a high risk of cardiovascular disease (CVD). This study aimed to elucidate whether serum uric acid (SUA) is associated with development of moderate coronary artery calcification in generally healthy adults.

METHODS

A total of 9297 subjects underwent multidetector CT for the evaluation of CAC at least two times during their annual health examinations. Among them, 4461 participants without CVD history and who had no (scores 0) or minimal CAC (scores 1-10) in their first examination were enrolled. The association between SUA as a continuous and categorical variable and development of moderate coronary artery calcification (CAC score > 100) was assessed by Cox regression analysis. Receiver-operating characteristic (ROC) curves were constructed to investigate the diagnostic efficacy of SUA.

RESULTS

During a median follow-up of 4.1 years, 131 incident cases of moderate calcification developed. Baseline SUA concentration was significantly higher in subjects with progression to moderate coronary artery calcification (6.6 ± 1.3 vs. 5.8 ± 1.3 mg/dL, p < 0.001). SUA as a continuous variable (per 1 mg/dL) and divided into quartiles was positively associated with a higher risk of development of moderate calcification after adjustment for conventional CVD risk factors. The addition of SUA to the conventional CVD risk factors improved the predictive power for development of moderate coronary artery calcification.

CONCLUSIONS

SUA was an independent predictor for development of moderate coronary artery calcification in subjects with no or minimal calcification.

摘要

背景与目的

高心血管疾病(CVD)风险人群常伴有高尿酸血症。本研究旨在阐明血尿酸(SUA)与一般健康成年人中中等程度冠状动脉钙化的发展是否相关。

方法

共有 9297 名受试者在年度健康检查中至少两次接受多排 CT 评估 CAC。其中,纳入 4461 名无 CVD 病史且首次检查时无(评分 0)或轻度 CAC(评分 1-10)的参与者。采用 Cox 回归分析评估 SUA 作为连续和分类变量与中等程度冠状动脉钙化(CAC 评分>100)发展之间的关系。构建受试者工作特征(ROC)曲线以探讨 SUA 的诊断效能。

结果

在中位随访 4.1 年期间,有 131 例发生中等程度钙化的病例。进展为中度冠状动脉钙化的受试者的基线 SUA 浓度显著更高(6.6±1.3 vs. 5.8±1.3 mg/dL,p<0.001)。SUA 作为连续变量(每 1mg/dL)和分为四分位数与调整传统 CVD 危险因素后中等程度钙化发展的风险增加呈正相关。将 SUA 添加到传统 CVD 危险因素中可提高对中度冠状动脉钙化发展的预测能力。

结论

在无或轻度钙化的受试者中,SUA 是中等程度冠状动脉钙化发展的独立预测因子。

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