Center on Translational Neuroscience, College of Life and Environment Sciences, Minzu University of China, Beijing, China.
Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Int J Obes (Lond). 2021 Jul;45(7):1457-1463. doi: 10.1038/s41366-021-00810-9. Epub 2021 Apr 6.
This study aimed to examine the temporal relationship between body mass index (BMI) and uric acid (UA), and their joint effect on blood pressure (BP) in children and adults.
The longitudinal cohorts for temporal relationship analyses consisted of 564 and 911 subjects examined twice 5-14 years apart from childhood to adulthood. The cross-sectional cohorts for mediation analyses consisted of 3102 children and 3402 nondiabetic adults. Cross-lagged panel analysis models were used to examine the temporal relationship between BMI and UA, and mediation analysis models the mediation effect of UA on the BMI-BP association.
After adjusting for age, race, sex and follow-up years in children, and additionally smoking and alcohol drinking in adults, the path coefficients (standardized regression coefficients) from baseline BMI to follow-up UA (0.145 in children and 0.068 in adults) were significant, but the path coefficients from baseline UA to follow-up BMI (0.011 in children and 0.016 in adults) were not. In mediation analyses, indirect effects through UA on the BMI-systolic BP association were estimated at 0.028 (mediation effect = 8.8%) in children and 0.033 (mediation effect = 13.5%) in adults (P < 0.001 for both). Direct effects of BMI on systolic BP (0.289 in children and 0.212 in adults) were significant. The mediation effect parameters did not differ significantly between Blacks and Whites.
Changes in BMI precede alterations in UA, and the BMI-BP association is in part mediated through BMI-related increase in UA both in children and in adults. These findings have implications for addressing mechanisms of obesity hypertension beginning in early life.
本研究旨在探讨儿童和成人的体重指数（BMI）与尿酸（UA）之间的时间关系，以及它们对血压（BP）的联合影响。
时间关系分析的纵向队列包括 564 名和 911 名从儿童期到成年期两次相隔 5-14 年检查的受试者。中介分析的横断面队列包括 3102 名儿童和 3402 名非糖尿病成年人。交叉滞后面板分析模型用于检验 BMI 和 UA 之间的时间关系，中介分析模型检验 UA 对 BMI-BP 关联的中介效应。
在儿童中，调整年龄、种族、性别和随访年限，以及在成人中进一步调整吸烟和饮酒后，基线 BMI 到随访 UA 的路径系数（标准化回归系数）为 0.145（儿童）和 0.068（成人），具有统计学意义，但基线 UA 到随访 BMI 的路径系数为 0.011（儿童）和 0.016（成人），无统计学意义。在中介分析中，UA 对 BMI-收缩压关联的间接效应估计值分别为 0.028（中介效应=8.8%）和 0.033（中介效应=13.5%）（均 P<0.001）。BMI 对收缩压的直接效应分别为 0.289（儿童）和 0.212（成人），具有统计学意义。BMI 和 UA 之间的中介效应参数在黑人和白人之间无显著差异。
BMI 的变化先于 UA 的改变，BMI-BP 关联部分通过 BMI 相关的 UA 增加来介导，这在儿童和成人中均成立。这些发现对于从生命早期开始解决肥胖高血压的机制具有重要意义。
