Nakano Hiroki, Shiina Kazuki, Takahashi Takamichi, Kumai Kento, Fujii Masatsune, Iwasaki Yoichi, Matsumoto Chisa, Chikamori Taishiro, Yamashina Akira, Tomiyama Hirofumi
Department of Cardiology, Tokyo Medical University Tokyo Japan.
Circ Rep. 2021 Mar 18;3(4):227-233. doi: 10.1253/circrep.CR-21-0013.
This prospective observational study examined whether hyperuricemia may be associated with impaired left ventricular (LV) systolic function and increased cardiac load resulting from increased arterial stiffness. In 1,880 middle-aged (mean [±SD] age 45±9 years) healthy men, serum uric acid (UA) levels, pre-ejection period/ejection time (PEP/ET) ratio, serum N-terminal pro B-type natriuretic peptide (NT-proBNP) levels, and brachial-ankle pulse wave velocity (baPWV) were measured at the start and end of the 3-year study period. Linear regression analysis revealed that serum UA levels measured at baseline were significantly associated with the PEP/ET ratio, but not with serum NT-proBNP levels, measured at baseline (β=0.73×10, P<0.01) and at the end of the study period (β=0.68×10, P<0.01). The change in the PEP/ET ratio during the study period was significantly greater in the High-UA (UA >7 mg/dL in 2009 and 2012) than Low-UA (UA ≤7 mg/dL in 2009 and 2012) group. Mediation analysis demonstrated both direct and indirect (via increases in baPWV) associations between serum UA measured at baseline and the PEP/ET ratio measured at the end of the study period. In healthy middle-aged Japanese men, hyperuricemia may be associated with an accelerated decline in ventricular systolic function, both directly and indirectly, via increases in arterial stiffness.
这项前瞻性观察性研究探讨了高尿酸血症是否可能与左心室（LV）收缩功能受损以及动脉僵硬度增加导致的心脏负荷增加有关。在1880名中年（平均[±标准差]年龄45±9岁）健康男性中，在为期3年的研究期开始和结束时测量了血清尿酸（UA）水平、射血前期/射血时间（PEP/ET）比值、血清N末端B型利钠肽原（NT-proBNP）水平以及臂踝脉搏波速度（baPWV）。线性回归分析显示，基线时测量的血清UA水平与基线时（β=0.73×10，P<0.01）和研究期末（β=0.68×10，P<0.01）测量的PEP/ET比值显著相关，但与血清NT-proBNP水平无关。在高尿酸组（2009年和2012年UA>7mg/dL）中，研究期间PEP/ET比值的变化显著大于低尿酸组（2009年和2012年UA≤7mg/dL）。中介分析表明，基线时测量的血清UA与研究期末测量的PEP/ET比值之间存在直接和间接（通过baPWV增加）关联。在健康的中年日本男性中，高尿酸血症可能直接和间接地通过动脉僵硬度增加与心室收缩功能的加速下降有关。
