35岁及以下疑似冠心病的年轻成年人中的高尿酸血症与吸烟：一项基于医院的观察性研究。
Hyperuricemia and smoking in young adults suspected of coronary artery disease ≤ 35 years of age: a hospital-based observational study.
作者信息
Lv Sai, Liu Wei, Zhou Yujie, Liu Yuyang, Shi Dongmei, Zhao Yingxin, Liu Xiaoli
机构信息
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Anzhen Ave #2, Chaoyang District, Beijing, 100029, China.
出版信息
BMC Cardiovasc Disord. 2018 Aug 31;18(1):178. doi: 10.1186/s12872-018-0910-5.
BACKGROUND
Coronary artery disease (CAD) is showing an increasing trend in young adults. Cigarette smoking has been shown to be a major cause of premature CAD. Previous studies have also shown that hyperuricemia (HUA) is associated with CAD; however, the interaction effect between HUA and smoking on CAD is uncertain. Therefore, this study was designed to determine the relationship and interactive effects of HUA and smoking on the risk of CAD in young adults ≤ 35 years of age.
METHODS
In this observational study we consecutively included adults (18-35 years of age) with suspected CAD who underwent coronary angiography for the first time in our institution from January 2005 to December 2015. Patients with stenosis affecting ≥50% of the luminal diameter and acute myocardial infarction were considered to have CAD. A serum uric acid (SUA) level ≥ 7.0 mg / dl (420 mmol / L) in males and ≥ 6.0 mg / dl (357 mmol / L) in females was defined as hyperuricemia. We tested for an interaction between HUA and cigarrete smoking on CAD. The relationship between HUA, cigarrete smoking, and CAD was assessed by multivariate logistic regression analysis.
RESULTS
A total of 1113 participants were included in this study; 771 participants were confirmed to have CAD. HUA was present in 34.8% of the participants. HUA was significantly higher in the CAD group (odds ratio [OR], 1.34; 95% confidence interval [CI], 1.02-1.76; p = 0.035). More smokers were in the CAD group (OR, 1.59; 95% CI, 1.22-2.07; p = 0.001). Based on multivariate regression analysis and after adjustment for age, BMI, high LDL-C level, low HDL-C level, hypercholesterolemia, hypertriglyceridemia, metabolic syndrome, diabetes mellitus, and hypertension, HUA was shown to be strongly associated with the presence of CAD in non-smokers (OR, 1.84; 95% CI, 1.03-3.29; p = 0.039). We further demonstrated that the interaction between HUA and cigarrete smoking achieved statistical significance for the presence of CAD (p = 0.008).
CONCLUSIONS
In the current study, HUA was shown to be associated with the presence of CAD in non-smokers ≤ 35 years of age.
背景
冠状动脉疾病（CAD）在年轻人中的发病率呈上升趋势。吸烟已被证明是CAD过早发生的主要原因。先前的研究还表明，高尿酸血症（HUA）与CAD有关；然而，HUA与吸烟对CAD的交互作用尚不确定。因此，本研究旨在确定HUA与吸烟对35岁及以下年轻人患CAD风险的关系及交互作用。
方法
在这项观察性研究中，我们连续纳入了2005年1月至2015年12月在我们机构首次接受冠状动脉造影的疑似CAD的成年人（18 - 35岁）。管腔直径狭窄≥50%和急性心肌梗死的患者被认为患有CAD。男性血清尿酸（SUA）水平≥7.0mg/dl（420mmol/L），女性≥6.0mg/dl（357mmol/L）被定义为高尿酸血症。我们测试了HUA与吸烟对CAD的交互作用。通过多因素逻辑回归分析评估HUA、吸烟与CAD之间的关系。
结果
本研究共纳入1113名参与者；771名参与者被确诊患有CAD。34.8%的参与者存在HUA。CAD组的HUA明显更高（比值比[OR]，1.34；95%置信区间[CI]，1.02 - 1.76；p = 0.035）。CAD组吸烟者更多（OR，1.59；95%CI，1.22 - 2.07；p = 0.001）。基于多因素回归分析，并在调整年龄、体重指数、高LDL-C水平、低HDL-C水平、高胆固醇血症、高甘油三酯血症、代谢综合征、糖尿病和高血压后，HUA被证明与非吸烟者患CAD密切相关（OR，1.84；95%CI，1.03 - 3.29；p = 0.039）。我们进一步证明，HUA与吸烟之间的交互作用对CAD的存在具有统计学意义（p = 0.008）。
结论
在本研究中，HUA被证明与35岁及以下非吸烟者患CAD有关。
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