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高血压和高三酰甘油血症与高尿酸血症发病的相关性:一项 8 年前瞻性队列研究。

Association of hypertension and hypertriglyceridemia on incident hyperuricemia: an 8-year prospective cohort study.

机构信息

School of Public Health, Tianjin Medical University, Tianjin, 300070, China.

Department of Genetics, School of Basic Medical Sciences, Tianjin Medical University, Tianjin, 300070, China.

出版信息

J Transl Med. 2020 Oct 31;18(1):409. doi: 10.1186/s12967-020-02590-8.

Abstract

BACKGROUND

Hypertension and high triglyceride are two of the most important risk factors for hyperuricemia. Epidemiological records show that hypertension and dyslipidemia often coexist and may significantly increase the risk of target organ damage. However, their combined effect on incident hyperuricemia is poorly understood. Thus, we aimed to investigate the separate and combined effect of hypertension and hypertriglyceridemia on the incidence of hyperuricemia.

METHODS

A prospective cohort study of 6424 hyperuricemia-free participants aged 20 to 94 years between August 2009 and October 2017 was performed at Tianjin General Hospital of China. Participants were categorized into four groups by combining hypertension and hypertriglyceridemia status at baseline. The restricted cubic spline fitting Cox regression model was used to evaluate the relationship between blood pressure and triglyceride and hyperuricemia. Cox regression models were performed to calculate hazard ratios (HRs) and 95% confident intervals (CIs) to estimate baseline factors and their association with the incidence of hyperuricemia. A Kaplan-Meier survival analysis was performed to compare the incidence of hyperuricemia among subjects in each separate and combined hypertension and hypertriglyceridemia group.

RESULTS

During the 8-year follow-up period, 1259 subjects developed hyperuricemia (20.6%). There existed positive relationships between blood pressure and triglyceride levels and hyperuricemia. This risk factor arising from a combination of the two (HR, 3.02; 95% CI 2.60-3.50) is greater than that from hypertension (HR, 1.48; 95% CI 1.28-1.71) or hypertriglyceridemia (HR, 1.84; 95% CI 1.55-2.18) separately. The Kaplan-Meier survival analysis indicated that combined effect of hypertension and hypertriglyceridemia may predict higher onset of hyperuricemia.

CONCLUSION

The combined effect of hypertension and hypertriglyceridemia on the risk of hyperuricemia is much stronger than that by hypertension or hypertriglyceridemia separately. Hypertension combined with hypertriglyceridemia may be an independent and powerful predictor for hyperuricemia.

摘要

背景

高血压和高甘油三酯是高尿酸血症最重要的两个危险因素。流行病学记录表明,高血压和血脂异常常并存,并可能显著增加靶器官损害的风险。然而,它们对高尿酸血症发病的联合影响知之甚少。因此,我们旨在研究高血压和高甘油三酯血症对高尿酸血症发病的单独和联合作用。

方法

对 2009 年 8 月至 2017 年 10 月在中国天津总医院就诊的 6424 例血尿酸正常的 20 至 94 岁参与者进行前瞻性队列研究。根据基线时高血压和高甘油三酯血症的状态将参与者分为四组。采用限制性立方样条拟合 Cox 回归模型评估血压和甘油三酯与高尿酸血症之间的关系。采用 Cox 回归模型计算危险比(HR)和 95%置信区间(CI),以评估基线因素及其与高尿酸血症发病的关系。Kaplan-Meier 生存分析用于比较每组中单独和联合高血压和高甘油三酯血症患者高尿酸血症的发生率。

结果

在 8 年的随访期间,1259 例患者发生高尿酸血症(20.6%)。血压和甘油三酯水平与高尿酸血症之间存在正相关关系。这两种因素共同作用产生的风险(HR,3.02;95%CI,2.60-3.50)大于高血压(HR,1.48;95%CI,1.28-1.71)或高甘油三酯血症(HR,1.84;95%CI,1.55-2.18)分别产生的风险。Kaplan-Meier 生存分析表明,高血压和高甘油三酯血症的联合作用可能预示着高尿酸血症的更高发病。

结论

高血压和高甘油三酯血症联合作用对高尿酸血症的风险强于高血压或高甘油三酯血症单独作用。高血压合并高甘油三酯血症可能是高尿酸血症的一个独立且强有力的预测因子。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8f1b/7603698/c2f7956d3587/12967_2020_2590_Fig1_HTML.jpg

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