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我们是否应该更加关注高尿酸血症的性别方面?基于人群的德国成年人健康访谈和检查调查(DEGS1)的分析。

Should we be more aware of gender aspects in hyperuricemia? Analysis of the population-based German health interview and examination survey for adults (DEGS1).

机构信息

Department of Health Services Research, Carl von Ossietzky University Oldenburg, Oldenburg, Germany.

Department of Health Services Research, Carl von Ossietzky University Oldenburg, Oldenburg, Germany.

出版信息

Maturitas. 2021 Nov;153:33-40. doi: 10.1016/j.maturitas.2021.08.002. Epub 2021 Aug 8.

Abstract

OBJECTIVES

While gout is a well-known entity, little research has been conducted on its pathophysiology. There is growing evidence that women with hyperuricemia are at higher cardiovascular risk than men with hyperuricemia. We aim to evaluate whether gender-specific cut-offs should be considered.

STUDY DESIGN

Cross-sectional study (the German Health Interview and Examination Survey for Adults; DEGS1).

MAIN OUTCOME MEASURES

Self-reported gout or hyperuricemia and uric acid level.

RESULTS

Of 6,918 participants (mean age 47.2 years; 50.5% females), 9.7% had had a diagnosis of hyperuricemia or gout at least once in their lifetime. Men were nearly twice as often affected as women (12.9 vs. 6.5%). In women, the prevalence of cardiovascular and renal diseases increased with higher uric acid level to a much greater extent than in men. This association remained in multivariate analyses.

CONCLUSIONS

No commonly accepted cut-off value for uric acid has been established. Overall, women were at lower risk of hyperuricemia. However, women were at higher risk of having cardiovascular and renal comorbidities, even at lower uric acid levels. Our results are in line with the accumulating evidence that we should consider gender in gout and hyperuricemia.

摘要

目的

尽管痛风是一种广为人知的疾病,但对其病理生理学的研究却很少。越来越多的证据表明,患有高尿酸血症的女性比患有高尿酸血症的男性患心血管疾病的风险更高。我们旨在评估是否应考虑性别特异性的切点。

研究设计

横断面研究(德国健康访谈和体检调查;DEGS1)。

主要观察指标

自述痛风或高尿酸血症及尿酸水平。

结果

在 6918 名参与者(平均年龄 47.2 岁,50.5%为女性)中,有 9.7%的人至少有一次被诊断为高尿酸血症或痛风。男性的患病比例几乎是女性的两倍(12.9%比 6.5%)。在女性中,心血管疾病和肾脏疾病的患病率随着尿酸水平的升高而增加,其程度远大于男性。这种相关性在多变量分析中仍然存在。

结论

目前尚未确定普遍接受的尿酸切点值。总的来说,女性患高尿酸血症的风险较低。然而,女性患心血管和肾脏合并症的风险更高,即使尿酸水平较低也是如此。我们的研究结果与越来越多的证据一致,即我们应该考虑痛风和高尿酸血症中的性别因素。

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