高血压患者的体重指数和腰围与新发高尿酸血症风险的关系。

Relation of BMI and waist circumference with the risk of new-onset hyperuricemia in hypertensive patients.

作者信息

Li Q, Li R, Zhang S, Zhang Y, Liu M, Song Y, Liu C, Liu L, Wang X, Wang B, Xu X, Qin X

机构信息

From the Institute of Biomedicine, Anhui Medical University, No.81 Meishan Road, Shushan District, Hefei 230032, China.

National Clinical Research Center for Kidney Disease, State Key Laboratory for Organ Failure Research, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Division of Nephrology, Nanfang Hospital, Southern Medical University, No.1838 Guangzhou Dadao North, Baiyun District, Guangzhou 510515, China.

出版信息

QJM. 2022 May 10;115(5):271-278. doi: 10.1093/qjmed/hcaa346.

DOI:10.1093/qjmed/hcaa346

PMID:33486528

Abstract

BACKGROUND

We aimed to evaluate the relationship of body mass index (BMI) and waist circumference (WC) with the risk of new-onset hyperuricemia, and examine possible effect modifies in general hypertensive patients.

METHODS

A total of 10 611 hypertensive patients with normal uric acid (UA) concentrations (<357 μmol/l) at baseline were included from the UA sub-study of the China Stroke Primary Prevention Trial. The primary outcome was new-onset hyperuricemia, defined as a UA concentration ≥417 μmol/l in men or ≥357 μmol/l in women at the exit visit.

RESULTS

During a median follow-up duration of 4.4 years, 1663 (15.7%) participants developed new-onset hyperuricemia. When analyzed separately, increased BMI (≥25 kg/m2, quartile 3-4; OR, 1.46; 95% CI: 1.29-1.65), or increased WC (≥85 cm for females, quartile 3-4; OR, 1.24; 95% CI: 1.08-1.42; and ≥84 cm for males, quartile 3-4; OR, 1.30; 95% CI: 1.01-1.67) were each significantly associated with higher risk of new-onset hyperuricemia. When WC was forced into the model with BMI simultaneously, its significant association with new-onset hyperuricemia disappeared in females (<85 vs. ≥85 cm; OR, 0.96, 95% CI: 0.81-1.13) or males (≥84 vs. <84 cm; OR, 1.13; 95% CI: 0.84-1.52); however, BMI was still significantly related with new-onset hyperuricemia (≥25 vs. <25 kg/m2; OR, 1.48; 95% CI: 1.27-1.73). Moreover, the positive BMI & new-onset hyperuricemia association was more pronounced in participants with higher time-averaged on-treatment systolic blood pressure (median: <138.3 vs. ≥138.3 mmHg; P-interaction = 0.041).

CONCLUSIONS

Higher BMI, but not WC, is significantly and independently associated with an increased risk of new-onset hyperuricemia among hypertensive patients.

摘要

背景

我们旨在评估体重指数（BMI）和腰围（WC）与新发高尿酸血症风险之间的关系，并研究一般高血压患者中可能的效应修饰因素。

方法

从中国卒中一级预防试验的尿酸亚研究中纳入了10611例基线尿酸（UA）浓度正常（<357μmol/l）的高血压患者。主要结局是新发高尿酸血症，定义为随访结束时男性UA浓度≥417μmol/l或女性≥357μmol/l。

结果

在中位随访4.4年期间，1663例（15.7%）参与者发生了新发高尿酸血症。单独分析时，BMI升高（≥25kg/m²，四分位数3 - 4；OR，1.46；95%CI：1.29 - 1.65），或WC增加（女性≥85cm，四分位数3 - 4；OR，1.24；95%CI：1.08 - 1.42；男性≥84cm，四分位数3 - 4；OR，1.30；95%CI：1.01 - 1.67）均与新发高尿酸血症的较高风险显著相关。当将WC与BMI同时纳入模型时，其与新发高尿酸血症的显著关联在女性（<85cm与≥85cm；OR，0.96，95%CI：0.81 - 1.13）或男性（≥84cm与<84cm；OR，1.13；95%CI：0.84 - 1.52）中消失；然而，BMI仍与新发高尿酸血症显著相关（≥25kg/m²与<25kg/m²；OR，1.48；95%CI：1.27 - 1.73）。此外，在治疗期间平均收缩压较高的参与者中，BMI与新发高尿酸血症的正相关更为明显（中位数：<138.3mmHg与≥138.3mmHg；P交互作用 = 0.041）。