Division of Renal Diseases and Hypertension, School of Medicine, University of Colorado Denver, CO, USA; Department of Cardiology, Toranomon Hospital, Tokyo, Japan; Cardiovascular Center, St. Luke's International Hospital, Tokyo, Japan.
Medical and Surgical Sciences Department, University of Bologna, Italy.
Int J Cardiol. 2018 Jun 15;261:183-188. doi: 10.1016/j.ijcard.2018.03.045. Epub 2018 Mar 13.
High serum uric acid (SUA) is associated with the dyslipidemia, but whether hyperuricemia predicts an increase in serum low-density lipoprotein (LDL) cholesterol is unknown. This study is to evaluate whether an elevated SUA predicts the development of high LDL cholesterol as well as hypertriglyceridemia.
This is a retrospective 5-year cohort study of 6476 healthy Japanese adults (age, 45.7 ± 10.1 years; 2.243 men) who underwent health examinations at 2004 and were reevaluated in 2009 at St. Luke's International Hospital, Tokyo, Japan. Subjects were included if at their baseline examination they did not have hypertension, diabetes mellitus, dyslipidemia, chronic kidney disease, or if they were on medication for hyperuricemia and/or gout. The analysis was adjusted for age, body mass index (BMI), smoking and drinking habits, baseline estimated glomerular filtration rate (eGFR), baseline SUA and SUA change over the 5 years.
High baseline SUA was an independent risk for developing high LDL cholesterol both in men (OR: 1.159 per 1 mg/dL increase, 95% CI:1.009-1.331) and women (OR: 1.215, 95% CI:1.061-1.390). Other risk factors included a higher baseline LDL cholesterol, higher BMI, and higher baseline eGFR (the latter two in women only). Increased SUA over 5 years were also independent risks for developing high LDL cholesterol and hypertriglyceridemia, but not for low high-density lipoprotein (HDL) cholesterol.
This is the first study to report that an elevated SUA increases the risk for developing high LDL cholesterol, as well as hypertriglyceridemia. This may shed light into the role of SUA in cardiovascular disease.
高血清尿酸（SUA）与血脂异常有关，但高尿酸血症是否会导致血清低密度脂蛋白（LDL）胆固醇升高尚不清楚。本研究旨在评估血清尿酸升高是否可预测 LDL 胆固醇升高以及高甘油三酯血症的发生。
这是一项回顾性的 5 年队列研究，纳入了 6476 名在 2004 年接受健康检查且无高血压、糖尿病、血脂异常、慢性肾脏病的日本健康成年人（年龄为 45.7±10.1 岁，男性 2243 人），并于 2009 年在日本东京圣卢克国际医院重新进行评估。如果在基线检查时受试者未服用治疗高尿酸血症和/或痛风的药物，且不存在高血压、糖尿病、血脂异常、慢性肾脏病，则将其纳入研究。分析时，调整了年龄、体重指数（BMI）、吸烟和饮酒习惯、基线估计肾小球滤过率（eGFR）、基线 SUA 及 5 年内 SUA 的变化。
在男性（OR：每增加 1mg/dL，1.159；95%CI：1.009-1.331）和女性（OR：1.215，95%CI：1.061-1.390）中，高基线 SUA 是发生 LDL 胆固醇升高的独立危险因素。其他危险因素包括基线 LDL 胆固醇升高、BMI 升高和基线 eGFR 升高（后两者仅在女性中存在）。5 年内 SUA 升高也是发生 LDL 胆固醇升高和高甘油三酯血症的独立危险因素，但不会引起高密度脂蛋白（HDL）胆固醇降低。
这是第一项报道血清尿酸升高会增加发生 LDL 胆固醇升高以及高甘油三酯血症风险的研究。这可能为尿酸在心血管疾病中的作用提供了新的视角。
