Hu Jia-Wen, Wang Yang, Chu Chao, Yan Yu, Wang Keke, Zheng Wenling, Ma Qiong, Lv Yong-Bo, Deng Yin, Yan Bo, Mu Jian-Jun
Department of Cardiology, First Affiliated Hospital of Medical School, Xi'an Jiaotong University, Xi'an, China.
Key Laboratory of Molecular Cardiology of Shaanxi Province, Xi'an, China.
Kidney Blood Press Res. 2018;43(1):234-245. doi: 10.1159/000487677. Epub 2018 Mar 20.
BACKGROUND/AIMS: Elevated serum uric acid (UA) was intimately correlated with vascular stiffness and abnormal ankle brachial index (ABI) in various populations. These correlations lost significance after adjustment for estimated glomerular filtration rate (eGFR), indicating that the association of UA and brachial-ankle pulse wave velocity (baPWV) or ABI might be driven by kidney function. UA is predominantly eliminated through the kidneys, and metabolic disorders can influence the clearance of UA. In this study, we aimed to explore the putative correlation between FEUA and baPWV or ABI to determine to what extent the associations with UA were affected by renal function.
This cross-sectional study enrolled 2351 participants, who underwent general health screening in Hanzhong people's hospital from March to June of 2017. BaPWV and ABI were measured using a volume-plethysmographic apparatus (BP-203RPEII; Nihon Colin, Tokyo, Japan). FEUA was divided into quartiles: Q1:FEUA≤3.07; Q2: 3.07<FEUA≤5.32; Q3: 5.32<FEUA≤9.19; and Q4: FEUA> 9.19.
Lower FEUA predicted a higher prevalence of high baPWV and low ABI (p for trend <0.001). The respective ORs for high baPWV from the first to the third quartiles of FEUA were 1.777(1.323, 2.387); 1.561(1.158, 2.104); and 1.680 (1.250, 2.259). The prevalence of low ABI was greatly elevated with the decrement of FEUA [ORs for the first to third FEUA quartiles were 6.977(2.062, 23.610); 5.123(1.475, 17.790); and 2.685(0.709, 10.171), respectively]. The association of FEUA and ABI was independent of related confounding factors. However, the association between FEUA and baPWV was greatly influenced by corresponding confounders, especially gender. The efficacy of FEUA in the prediction of low ABI was stronger than that of serum UA. However, serum UA was more powerful in the prediction of high baPWV.
Kidney function exerted a profound influence on the relationship between UA and baPWV or ABI, revealing complex interactions among cardiovascular risk factors.
背景/目的：在不同人群中，血清尿酸（UA）升高与血管僵硬度及踝臂指数（ABI）异常密切相关。在调整估算肾小球滤过率（eGFR）后，这些相关性失去意义，这表明UA与臂踝脉搏波速度（baPWV）或ABI之间的关联可能受肾功能驱动。UA主要通过肾脏排泄，代谢紊乱会影响UA的清除。在本研究中，我们旨在探讨尿酸排泄分数（FEUA）与baPWV或ABI之间的潜在相关性，以确定肾功能对UA相关关系的影响程度。
这项横断面研究纳入了2351名参与者，他们于2017年3月至6月在汉中市人民医院接受了全面健康筛查。使用体积描记仪（BP - 203RPEII；日本尼弘科林公司，东京）测量baPWV和ABI。FEUA被分为四分位数：Q1：FEUA≤3.07；Q2：3.07＜FEUA≤5.32；Q3：5.32＜FEUA≤9.19；Q4：FEUA＞9.19。
较低的FEUA预示着高baPWV和低ABI的患病率较高（趋势p＜0.001）。FEUA从第一到第三四分位数时，高baPWV的相应比值比（OR）分别为1.777（1.323，2.387）；1.561（1.158，2.104）；1.680（1.250，2.259）。随着FEUA的降低，低ABI的患病率大幅升高[FEUA第一到第三四分位数的OR分别为6.977（2.062，23.610）；5.123（1.475，17.790）；2.685（0.709，10.171）]。FEUA与ABI的关联独立于相关混杂因素。然而，FEUA与baPWV之间的关联受到相应混杂因素的极大影响，尤其是性别。FEUA预测低ABI的效能强于血清UA。然而，血清UA在预测高baPWV方面更强。
肾功能对UA与baPWV或ABI之间的关系有深远影响，揭示了心血管危险因素之间复杂的相互作用。
