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血清尿酸与高血压前期风险:一项对约7.9万名参与者的17项观察性研究的剂量反应荟萃分析。

Serum uric acid and risk of prehypertension: a dose-response meta-analysis of 17 observational studies of approximately 79 thousand participants.

作者信息

Liu Leilei, Zhang Xiao, Li Quanman, Qie Ranran, Han Minghui, Zhan Shaohui, Zhang Juntao, Zhang Linyuan, Zhang Cailiang, Hong Feng

机构信息

School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China.

College of Public Health, Zhengzhou University, Zhengzhou, China.

出版信息

Acta Cardiol. 2022 Apr;77(2):136-145. doi: 10.1080/00015385.2021.1878422. Epub 2021 Mar 8.

Abstract

BACKGROUND

Studies examining the association between levels of serum uric acid (SUA) and risk of prehypertension still remained controversial conclusions. Also, a quantitative assessment of the dose-response association between them has not been reported. We aimed to quantitatively evaluate risk of prehypertension with levels of SUA based on observational study.

METHODS

We searched the PubMed, Embase, and Web of Science databases up to December 3, 2019 for relevant studies. Pooled relative risks (RRs) and 95% confidence intervals (CIs) were calculated using random-effects models. The possible linear or non-linear SUA-prehypertension association was modelled by restricted cubic splines.

RESULTS

We included 17 articles (17 studies) with a total of 79,358 participants and 34,591 cases of prehypertension. Compared with lowest levels of SUA, risk of prehypertension increased 46% (RR 1.46, 95% CI 1.28-1.66) for highest levels of SUA. For per 1 mg/dL increment in levels of SUA, risk of prehypertension increased by 12% (RR 1.12, 95% CI 1.08-1.17). Also, we found evidence of a linear SUA-prehypertension association (=.368).

CONCLUSION

Elevated levels of SUA may be associated with increased risk of prehypertension. Present findings provide the evidence that lowering levels of SUA should be suggested in order to reduce the risk of prehypertension. More longitudinal and intervention studies are needed to clarify the optimal protective levels and whether reducing levels of SUA could prevent or control prehypertension and the progression of prehypertension to hypertension.

摘要

背景

关于血清尿酸(SUA)水平与高血压前期风险之间关联的研究仍存在争议性结论。此外,尚未有关于二者剂量反应关联的定量评估报告。我们旨在基于观察性研究对高血压前期风险与SUA水平进行定量评估。

方法

我们检索了截至2019年12月3日的PubMed、Embase和Web of Science数据库中的相关研究。使用随机效应模型计算合并相对风险(RRs)和95%置信区间(CIs)。通过受限立方样条对SUA与高血压前期之间可能的线性或非线性关联进行建模。

结果

我们纳入了17篇文章(17项研究),共计79358名参与者和34591例高血压前期病例。与最低SUA水平相比,最高SUA水平时高血压前期风险增加46%(RR 1.46,95% CI 1.28 - 1.66)。SUA水平每升高1mg/dL,高血压前期风险增加12%(RR 1.12,95% CI 1.08 - 1.17)。此外,我们发现了SUA与高血压前期之间存在线性关联的证据(P =.368)。

结论

SUA水平升高可能与高血压前期风险增加相关。目前的研究结果提供了证据,表明应建议降低SUA水平以降低高血压前期风险。需要更多的纵向研究和干预研究来阐明最佳保护水平,以及降低SUA水平是否可以预防或控制高血压前期以及高血压前期向高血压的进展。

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