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血清尿酸水平升高对代谢综合征发展的保护作用。

The Protective Effects of Increasing Serum Uric Acid Level on Development of Metabolic Syndrome.

机构信息

Division of Endocrinology and Metabolism, Department of Medicine, Wonkwang Medical Center, Wonkwang University School of Medicine, Iksan, Korea.

Department of Medicine, Sungkyunkwan University Graduate School of Medicine, Seoul, Korea.

出版信息

Diabetes Metab J. 2019 Aug;43(4):504-520. doi: 10.4093/dmj.2018.0079. Epub 2019 Feb 21.

Abstract

BACKGROUND

It has not been determined whether changes in serum uric acid (SUA) level are associated with incident metabolic syndrome (MetS). The aim of the current study was to investigate the relationship between changes in SUA level and development of MetS in a large number of subjects.

METHODS

In total, 13,057 subjects participating in a medical health check-up program without a diagnosis of MetS at baseline were enrolled. Cox proportional hazards models were used to test the independent association of percent changes in SUA level with development of MetS.

RESULTS

After adjustment for age, systolic blood pressure, body mass index, fat-free mass (%), estimated glomerular filtration rate, smoking status, fasting glucose, triglyceride, low density lipoprotein cholesterol, high density lipoprotein cholesterol, and baseline SUA levels, the hazard ratios (HRs) (95% confidence intervals [CIs]) for incident MetS in the second, third, and fourth quartiles compared to the first quartile of percent change in SUA level were 1.055 (0.936 to 1.190), 0.927 (0.818 to 1.050), and 0.807 (0.707 to 0.922) in male ( for trend <0.001) and 1.000 (0.843 to 1.186), 0.744 (0.615 to 0.900), and 0.684 (0.557 to 0.840) in female ( for trend <0.001), respectively. As a continuous variable in the fully-adjusted model, each one-standard deviation increase in percent change in SUA level was associated with an HR (95% CI) for incident MetS of 0.944 (0.906 to 0.982) in male (=0.005) and 0.851 (0.801 to 0.905) in female (<0.001).

CONCLUSION

The current study demonstrated that increasing SUA level independently protected against the development of MetS, suggesting a possible role of SUA as an antioxidant in the pathogenesis of incident MetS.

摘要

背景

血清尿酸(SUA)水平的变化是否与代谢综合征(MetS)的发生有关尚不确定。本研究的目的是在大量人群中研究 SUA 水平变化与 MetS 发展之间的关系。

方法

共纳入 13057 名基线时无 MetS 诊断的参加医疗健康检查计划的受试者。使用 Cox 比例风险模型检验 SUA 水平变化百分比与 MetS 发展的独立相关性。

结果

在校正年龄、收缩压、体重指数、去脂体重(%)、估计肾小球滤过率、吸烟状况、空腹血糖、甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇和基线 SUA 水平后,SUA 水平变化百分比第二、第三和第四四分位数与第一四分位相比,男性发生 MetS 的风险比(HR)(95%置信区间[CI])分别为 1.055(0.936 至 1.190)、0.927(0.818 至 1.050)和 0.807(0.707 至 0.922)(趋势<0.001),女性分别为 1.000(0.843 至 1.186)、0.744(0.615 至 0.900)和 0.684(0.557 至 0.840)(趋势<0.001)。作为完全调整模型中的连续变量,SUA 水平变化百分比每增加一个标准差,男性发生 MetS 的 HR(95%CI)为 0.944(0.906 至 0.982)(=0.005),女性为 0.851(0.801 至 0.905)(<0.001)。

结论

本研究表明,SUA 水平升高可独立预防 MetS 的发生,提示 SUA 作为抗氧化剂在 MetS 发病机制中可能发挥作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a626/6712225/b747567b93a1/dmj-43-504-g001.jpg

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