Department of Internal Medicine, Pusan National University School of Medicine, Yangsan, Republic of Korea.
Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea.
PLoS One. 2021 May 6;16(5):e0251333. doi: 10.1371/journal.pone.0251333. eCollection 2021.
The level of serum uric acid (SUA) has been reported to be associated with left ventricular hypertrophy (LVH) and left ventricular diastolic dysfunction (LVDD). However, this association remains unclear in patients with chronic kidney disease (CKD).
A total of 1025 patients with pre-dialysis CKD with preserved left ventricular systolic function were enrolled in this cross-sectional study. The LVH and LVDD were assessed using two-dimensional echocardiography and tissue Doppler imaging. The associations of LVH/LVDD with clinical and laboratory variables were investigated using univariable and multivariable logistic regression analyses.
In a multivariable analysis, the SUA level was an independent predictor of LVH (odds ratio [OR]: 1.40, 95% confidence interval [CI]: 1.31-1.50, P < 0.001). In addition, patient age, systolic blood pressure, intact parathyroid hormone levels, and left atrial volume index levels were independent predictors of LVH. The SUA level was also an independent predictor of LVDD (OR: 1.93, 95% CI: 1.53-2.43, P < 0.001). Furthermore, systolic blood pressure and left atrial volume index levels were an independent predictor of LVDD. Receiver-operating characteristic curve analysis showed that the best cutoff values of SUA levels for identifying LVH and LVDD were ≥ 7.5 mg/dL and ≥ 6.3 mg/dL, respectively.
The SUA level was an independent predictor of LVD and LVDD in patients with CKD, suggesting that SUA could be a biomarker for LVH and LVDD.
已有研究报道血清尿酸（SUA）水平与左心室肥厚（LVH）和左心室舒张功能障碍（LVDD）相关。然而，在慢性肾脏病（CKD）患者中，这种相关性尚不清楚。
本横断面研究共纳入了 1025 例接受透析前 CKD 且左心室收缩功能正常的患者。采用二维超声心动图和组织多普勒成像评估 LVH 和 LVDD。采用单变量和多变量逻辑回归分析评估 LVH/LVDD 与临床和实验室变量的相关性。
多变量分析显示，SUA 水平是 LVH 的独立预测因素（比值比[OR]：1.40，95%置信区间[CI]：1.31-1.50，P<0.001）。此外，患者年龄、收缩压、全段甲状旁腺激素水平和左心房容积指数水平也是 LVH 的独立预测因素。SUA 水平也是 LVDD 的独立预测因素（OR：1.93，95%CI：1.53-2.43，P<0.001）。此外，收缩压和左心房容积指数水平也是 LVDD 的独立预测因素。受试者工作特征曲线分析显示，SUA 水平用于诊断 LVH 和 LVDD 的最佳截断值分别为≥7.5mg/dL 和≥6.3mg/dL。
SUA 水平是 CKD 患者 LVH 和 LVDD 的独立预测因素，提示 SUA 可能是 LVH 和 LVDD 的生物标志物。
