Department of Rheumatology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.
Department of Thoracic and Cardiovascular Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea.
Atherosclerosis. 2019 Sep;288:112-117. doi: 10.1016/j.atherosclerosis.2019.07.017. Epub 2019 Jul 19.
There are limited data on the association between serum uric acid (SUA) level and subclinical coronary atherosclerosis. This study investigated the influence of SUA level on subclinical coronary atherosclerosis, as detected by coronary computed tomography angiography (CCTA), in an asymptomatic population.
We evaluated 6431 asymptomatic individuals (mean age 53.6 ± 7.6 years, 4691 men [72.9%]) with no prior history of coronary artery disease, who voluntarily underwent laboratory tests and CCTA as part of a general health examination. The participants were stratified into quartiles according to their SUA levels. Coronary atherosclerotic plaques (calcified, mixed, and non-calcified plaques) were assessed using CCTA. Logistic regression analysis was used to determine the association between SUA levels and subclinical coronary atherosclerosis.
The prevalence of any atherosclerotic, calcified, mixed, and non-calcified plaques increased with SUA quartiles (all p < 0.001). After adjustment for cardiovascular risk factors, there were no statistically significant differences in the adjusted odds ratios for calcified plaque (1.19; 95% CI 0.98-1.46; p = 0.080) and mixed plaque (1.25; 95% CI 0.94-1.67; p = 0.132) in the fourth SUA quartile compared to the first quartile. However, the adjusted odds ratios for any atherosclerotic plaque (1.39; 95% CI 1.16-1.68; p < 0.001) and non-calcified plaque (1.38; 95% CI 1.11-1.72; p = 0.004) were significantly higher in the fourth SUA quartile.
In asymptomatic individuals, high SUA level was an independent predictor of non-calcified plaques, suggesting an increased cardiovascular risk.
血清尿酸（SUA）水平与亚临床冠状动脉粥样硬化之间的关联数据有限。本研究旨在调查无症状人群中 SUA 水平对冠状动脉计算机断层扫描血管造影（CCTA）检测到的亚临床冠状动脉粥样硬化的影响。
我们评估了 6431 名无症状个体（平均年龄 53.6±7.6 岁，4691 名男性[72.9%]），他们没有先前的冠状动脉疾病史，自愿接受实验室检查和 CCTA 作为一般健康检查的一部分。参与者根据 SUA 水平分为四组。使用 CCTA 评估冠状动脉粥样硬化斑块（钙化、混合和非钙化斑块）。使用逻辑回归分析确定 SUA 水平与亚临床冠状动脉粥样硬化之间的关联。
任何粥样硬化、钙化、混合和非钙化斑块的患病率随 SUA 四分位升高而增加（均 p<0.001）。在校正心血管危险因素后，第四 SUA 四分位与第一四分位相比，钙化斑块（1.19；95%CI 0.98-1.46；p=0.080）和混合斑块（1.25；95%CI 0.94-1.67；p=0.132）的校正比值比无统计学差异。然而，第四 SUA 四分位与第一四分位相比，任何粥样硬化斑块（1.39；95%CI 1.16-1.68；p<0.001）和非钙化斑块（1.38；95%CI 1.11-1.72；p=0.004）的校正比值比显著更高。
在无症状个体中，高 SUA 水平是无钙化斑块的独立预测因子，提示心血管风险增加。
