Shouling Wu, Department of Cardiology, Kailuan Hospital, Hebei United University, Tangshan, China, E-mail:
J Nutr Health Aging. 2021;25(10):1235-1241. doi: 10.1007/s12603-021-1706-3.
Uric acid(UA) is related with cardiovascular disease, but the association of UA variability with all-cause mortality is rarely known. This study aimed to investigate the relationship between UA variability and all-cause mortality in Kailuan cohort study in northern China.
Cohort study.
Kailuan community hospitals in Tangshan, Hebei province, Northern China.
A total of 55717 participants from Kailuan Study were enrolled, and our study followed up biennially from 2006 to 2010.
Clinical records of the participants enrolled were analyzed. UA variation independent of mean (UAVIM) values were calculated and all the participants were quartile grouped into four groups as: Q1(UAVIM<0.68), Q2(0.68≤UAVIM<1.10), Q3(1.10≤UAVIM<1.67) and Q4(UAVIM≥1.67). The endpoint event was all-cause death. Cox regression model was performed to evaluate the hazard ratios(HRs) of all-cause mortality based on UAVIM groups.
During a median follow-up of 6.83 years, 2926 deaths occurred. The accumulated mortality rates were 4.6%, 4.8%, 5.4% and 6.1% in group Q1, Q2, Q3 and Q4 respectively. When adjusted potential confounders, the highest risk for all-cause mortality was in group Q4 and the adjusted HRs and 95% confidence intervals(CIs) of group Q2-Q4 for all-cause death were 1.044(0.937, 1.164), 1.182(1.064, 1.314) and 1.353(1.220, 1.501) compared with group Q1, respectively. Further analysis showed that the risk for all-cause death increased as UAVIM value increased. Sensitive analysis still showed the similar results when excluding participants with hyperuricemia or severe chronic kidney diseases. Sub-group analysis by age, gender, BMI or hypertension history also indicated analogous results.
Elevated UAVIM was related with increased all-cause mortality and UAVIM was an independent risk factor for all-cause mortality in the community cohort study.
尿酸（UA）与心血管疾病有关，但 UA 变异性与全因死亡率的关系鲜为人知。本研究旨在探讨中国北方开滦队列研究中 UA 变异性与全因死亡率之间的关系。
队列研究。
中国河北省唐山市开滦社区医院。
共纳入 55717 名来自开滦研究的参与者，我们的研究从 2006 年至 2010 年每两年进行一次随访。
对纳入参与者的临床记录进行分析。计算了独立于均值的尿酸变异（UAVIM）值，并将所有参与者按四分位数分为四组：Q1（UAVIM<0.68）、Q2（0.68≤UAVIM<1.10）、Q3（1.10≤UAVIM<1.67）和 Q4（UAVIM≥1.67）。终点事件为全因死亡。基于 UAVIM 组，采用 Cox 回归模型评估全因死亡率的危险比（HRs）。
在中位随访 6.83 年期间，有 2926 人死亡。Q1、Q2、Q3 和 Q4 组的累积死亡率分别为 4.6%、4.8%、5.4%和 6.1%。在调整潜在混杂因素后，全因死亡率风险最高的是 Q4 组，Q2-Q4 组全因死亡的调整 HRs 和 95%置信区间（CIs）分别为 1.044（0.937，1.164）、1.182（1.064，1.314）和 1.353（1.220，1.501）与 Q1 组相比。进一步分析显示，随着 UAVIM 值的升高，全因死亡风险增加。敏感分析在排除高尿酸血症或严重慢性肾脏疾病患者后仍显示出类似结果。按年龄、性别、BMI 或高血压病史进行亚组分析也表明了类似的结果。
升高的 UAVIM 与全因死亡率增加相关，UAVIM 是社区队列研究中全因死亡率的独立危险因素。
