Chen Po-Chih, Wu Pei-Yu, Huang Jiun-Chi, Chen Szu-Chia, Huang Yeou-Lih
Department of Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan.
Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Oncotarget. 2018 Jan 4;9(9):8738-8745. doi: 10.18632/oncotarget.23981. eCollection 2018 Feb 2.
Hyperuricemia has been associated with low heart rate variability (HRV), however whether there is an association between uric acid (UA) and HRV changes after hemodialysis (HD) is unknown. The aim of this study was to investigate the role of UA in HRV changes before and after HD in non-diabetic patients. Ninety-six non-diabetic patients under maintenance HD were enrolled. HRV was examined to assess changes before and after HD. A change in HRV (ΔHRV) was calculated as post-HD HRV minus pre-HD HRV. Compared to the patients with a UA level ≦ 7 mg/dL, those with a UA level > 7 mg/dL had lower ∆high frequency (HF)% ( = 0.027). UA was negatively associated with ∆HF% ( = -0.247, = 0.015) and ∆low frequency (LF)/HF ( = -0.236, = 0.021) in the non-diabetic patients undergoing HD. Furthermore, in multivariate analysis after adjustments for demographic, clinical, and biochemical characteristics and medications, UA was independently associated with ∆HF% (per 1 mg/dL, unstandardized coefficient β = -2.892; 95% CI, -5.066 to -0.717; = 0.010) and ∆LF/HF (per 1 mg/dL, unstandardized coefficient β = -0.165; 95% CI, -0.291 to -0.038; = 0.011). Hyperuricemia contributed to lesser HF% and LF/HF increase after HD in the non-diabetic patients, reflecting a state of impaired sympatho-vagal equilibrium in non-diabetic HD patients with hyperuricemia. Lowering UA levels may have the potential to improve increased HRV in non-diabetic HD patients.
高尿酸血症与低心率变异性（HRV）有关，然而，尿酸（UA）与血液透析（HD）后HRV变化之间是否存在关联尚不清楚。本研究的目的是调查UA在非糖尿病患者HD前后HRV变化中的作用。纳入了96例维持性HD的非糖尿病患者。检测HRV以评估HD前后的变化。HRV变化（ΔHRV）计算为HD后HRV减去HD前HRV。与UA水平≤7mg/dL的患者相比，UA水平>7mg/dL的患者的高频（HF）%变化更低（=0.027）。在接受HD的非糖尿病患者中，UA与ΔHF%（=-0.247，=0.015）和Δ低频（LF）/HF（=-0.236，=0.021）呈负相关。此外，在对人口统计学、临床、生化特征和药物进行调整后的多变量分析中，UA与ΔHF%（每1mg/dL，未标准化系数β=-2.892；95%CI，-5.066至-0.717；=0.010）和ΔLF/HF（每1mg/dL，未标准化系数β=-0.165；95%CI，-0.291至-0.038；=0.011）独立相关。高尿酸血症导致非糖尿病患者HD后HF%和LF/HF增加较少，反映了高尿酸血症的非糖尿病HD患者交感-迷走神经平衡受损的状态。降低UA水平可能有改善非糖尿病HD患者HRV增加的潜力。
