Renal Division, Department of Medicine, Peking University First Hospital, Institute of Nephrology, Peking University, Beijing 100034, China.
Key Laboratory of Renal Disease, National Health Commission of the People's Republic of China, Beijing 100034, China.
Chin Med J (Engl). 2021 Jul 27;134(17):2073-2080. doi: 10.1097/CM9.0000000000001631.
Whether there is an association between serum uric acid (SUA) level and risk of mortality in the general population remains unclear. Based on the China National Survey of Chronic Kidney Disease linked to mortality data, a population-based cohort study was performed to investigate the association between SUA level and all-cause mortality, cardiovascular disease (CVD) mortality, and cancer mortality in China.
The survival status of participants in the cross-sectional survey was identified from January 1, 2006 to December 31, 2017. Only 33,268 individuals with complete SUA data among the 47,204 participants were included in the analysis. We determined the rates of all-cause mortality, CVD mortality, and cancer mortality. We used Cox proportional hazards regression models to evaluate the effect of the SUA level on mortality.
During a total of 297,538.4 person-years of follow-up, 1282 deaths occurred. In the Cox proportional hazards regression model, the rate of all-cause mortality, CVD mortality, and cancer mortality had a U-shaped association with SUA levels only in men, whereas no significant associations were detected in women. For all-cause mortality in men, the multivariable-adjusted hazard ratios (HRs) in the first, second, and fourth quartiles compared with the third quartile were 1.31 (95% confidence interval [CI] 1.04-1.67), 1.17 (95% CI 0.92-1.47), and 1.55 (95% CI 1.24-1.93), respectively. For CVD mortality, the corresponding HRs were 1.47 (95% CI 1.00-2.18), 1.17 (95% CI 0.79-1.75), and 1.67 (95% CI 1.16-2.43), respectively. For the cancer mortality rate, only a marginally significant association was detected in the fourth quartile compared with the third quartile with an HR of 1.43 (95% CI 0.99-2.08).
The association between SUA and mortality differed by sex. We demonstrated a U-shaped association with SUA levels for all-cause and CVD mortalities among men in China.
血清尿酸（SUA）水平与普通人群的死亡率之间是否存在关联尚不清楚。本研究基于中国慢性肾脏病与死亡相关的全国性调查数据，开展了一项基于人群的队列研究，旨在探讨中国人群中 SUA 水平与全因死亡率、心血管疾病（CVD）死亡率和癌症死亡率之间的关系。
本研究从 2006 年 1 月 1 日至 2017 年 12 月 31 日，对横断面调查参与者的生存状况进行了随访。在 47204 名参与者中，仅纳入了 33268 名具有完整 SUA 数据的个体进行分析。我们确定了全因死亡率、CVD 死亡率和癌症死亡率的发生率。采用 Cox 比例风险回归模型评估 SUA 水平对死亡率的影响。
在 297538.4 人年的随访期间，共发生 1282 例死亡。在 Cox 比例风险回归模型中，仅在男性中，全因死亡率、CVD 死亡率和癌症死亡率与 SUA 水平呈 U 型关联，而在女性中未观察到显著关联。对于男性的全因死亡率，与第三四分位相比，第一、二四分位的多变量校正风险比（HR）分别为 1.31（95%置信区间[CI]：1.04-1.67）、1.17（95%CI：0.92-1.47）和 1.55（95%CI：1.24-1.93）。对于 CVD 死亡率，相应的 HR 分别为 1.47（95%CI：1.00-2.18）、1.17（95%CI：0.79-1.75）和 1.67（95%CI：1.16-2.43）。对于癌症死亡率，仅在第四四分位与第三四分位之间观察到有边缘显著的关联，HR 为 1.43（95%CI：0.99-2.08）。
SUA 与死亡率之间的关系因性别而异。本研究在中国男性中发现，SUA 水平与全因和 CVD 死亡率之间呈 U 型关联。
