Yu Yu, Huang Xiao, Li Minghui, Ding Congcong, Hu Lihua, Zhong Xiao, Zhou Wei, Wang Tao, Zhu Lingjuan, Bao Huihui, Cheng Xiaoshu
Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
Center for Prevention and Treatment of Cardiovascular Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
Int J Endocrinol. 2020 Sep 18;2020:9725979. doi: 10.1155/2020/9725979. eCollection 2020.
Evidence regarding the nonlinear relationship between serum uric acid (SUA) and blood lipids in Chinese population with hypertension is limited. Therefore, the present study aimed to investigate whether there is a nonlinear association between SUA and lipids in Chinese hypertensive population with an estimated glomerular filtration rate (eGFR) ≥30 ml/min/1.73 m.
A total of 13,355 hypertensive participants with eGFR ≥30 ml/min/1.73 m were selected from the Chinese Hypertension Registry Study. Multivariate linear regression was used to examine the linear relationship between SUA and lipids. Smooth curve fitting (penalized spline method) and threshold saturation effects were used to analyze the nonlinear association between SUA and lipids.
In the fully adjusted model, the results showed a positive correlation between SUA and TG ( = 0.15; 95% CI: 0.14, 0.16) and LDL-C ( = 0.06; 95% CI: 0.05, 0.07), respectively. However, the relationship between SUA and HDL-C was nonlinear. The inflection point of SUA was 7.24 mg/dL. On the left side of the inflection point (<7.24 mg/dL), SUA was negatively associated with HDL-C ( = -0.02; 95% CI -0.02, -0.01). On the right side of the inflection point (≥7.24 mg/dL), SUA was not related to HDL-C ( = 0.01; 95% CI -0.01, 0.02).
After adjusting for all covariates, SUA was positively associated with TG and LDL-C. The relationship between SUA and HDL-C was nonlinear. The negative correlation between SUA and HDL-C only existed when the SUA was less than 7.24 mg/dL in a hypertensive population with eGFR ≥30 ml/min/1.73 m.
关于中国高血压人群中血清尿酸（SUA）与血脂之间非线性关系的证据有限。因此，本研究旨在调查估计肾小球滤过率（eGFR）≥30 ml/min/1.73 m²的中国高血压人群中SUA与血脂之间是否存在非线性关联。
从中国高血压注册研究中选取了13355例eGFR≥30 ml/min/1.73 m²的高血压参与者。采用多变量线性回归分析SUA与血脂之间的线性关系。采用平滑曲线拟合（惩罚样条法）和阈值饱和效应分析SUA与血脂之间的非线性关联。
在完全调整模型中，结果显示SUA分别与甘油三酯（β = 0.15；95%CI：0.14，0.16）和低密度脂蛋白胆固醇（β = 0.06；95%CI：0.05，0.07）呈正相关。然而，SUA与高密度脂蛋白胆固醇（HDL-C）之间的关系是非线性的。SUA的拐点为7.24 mg/dL。在拐点左侧（<7.24 mg/dL），SUA与HDL-C呈负相关（β = -0.02；95%CI -0.02，-0.01）。在拐点右侧（≥7.24 mg/dL），SUA与HDL-C无相关性（β = 0.01；95%CI -0.01，0.02）。
在调整所有协变量后，SUA与甘油三酯和低密度脂蛋白胆固醇呈正相关。SUA与HDL-C之间的关系是非线性的。在eGFR≥30 ml/min/1.73 m²的高血压人群中，仅当SUA低于7.24 mg/dL时，SUA与HDL-C才呈负相关。
