Hu Feng, Hu Longlong, Yu Rihua, Han Fengyu, Zhou Wei, Wang Tao, Zhu Linjuan, Huang Xiao, Bao Huihui, Cheng Xiaoshu
Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China.
Jiangxi Provincial Cardiovascular Disease Clinical Medical Research Center, Nanchang, China.
Front Physiol. 2021 Dec 23;12:807420. doi: 10.3389/fphys.2021.807420. eCollection 2021.
We investigated the association between serum uric acid (SUA) levels and the risk of the first stroke in Chinese adults with hypertension. A total of 11, 841 hypertensive patients were selected from the Chinese Hypertension Registry for analysis. The relationship between SUA levels and first stroke was determined using multivariable Cox proportional hazards regression, smoothing curve fitting, and Kaplan-Meier survival curve analysis. During a median follow-up of 614 days, 99 cases of the first stroke were occurred. Cox proportional hazards models indicated that SUA levels were not significantly associated with the first stroke event [adjusted-hazard ratio (HR) per SD increase: 0.98, 95% CI 0.76-1.26, = 0.889]. In comparison to the group without hyperuricemia (HUA), there were no significantly higher risks of first stroke events (adjustedHR: 1.22, 95% CI 0.79-1.90, = 0.373) in the population with HUA. However, in the population less than 60 years old, subjects with HUA had a significantly higher risk of the first stroke than the population without HUA (adjusted-HR: 4.89, 95% CI 1.36-17.63, = 0.015). In subjects older than 60 years, we did not find a significant relationship between HUA and first stroke (adjusted-HR: 0.97, 95% CI 0.60-1.56, = 0.886). Survival analysis further confirmed this discrepancy (log-rank = 0.013 or 0.899 for non-aging or aging group). No significant evidence in the present study indicated that increased SUA levels were associated with the risk of first stroke in the Chinese adults with hypertension. Age played an interactive role in the relationship between HUA and the first stroke event.
我们调查了中国成年高血压患者血清尿酸（SUA）水平与首次中风风险之间的关联。从中国高血压登记系统中选取了总共11841例高血压患者进行分析。使用多变量Cox比例风险回归、平滑曲线拟合和Kaplan-Meier生存曲线分析来确定SUA水平与首次中风之间的关系。在中位随访614天期间，发生了99例首次中风。Cox比例风险模型表明，SUA水平与首次中风事件无显著关联[每标准差增加的调整风险比（HR）：0.98，95%置信区间0.76 - 1.26，P = 0.889]。与无高尿酸血症（HUA）组相比，HUA人群首次中风事件的风险没有显著更高（调整后HR：1.22，95%置信区间0.79 - 1.90，P = 0.373）。然而，在60岁以下人群中，HUA患者首次中风的风险显著高于无HUA人群（调整后HR：4.89，95%置信区间1.36 - 17.63，P = 0.015）。在60岁以上人群中，我们未发现HUA与首次中风之间存在显著关系（调整后HR：0.97，95%置信区间0.60 - 1.56，P = 0.886）。生存分析进一步证实了这种差异（非老年或老年组的对数秩检验P = 0.013或0.899）。本研究中没有显著证据表明SUA水平升高与中国成年高血压患者首次中风风险相关。年龄在HUA与首次中风事件的关系中起交互作用。
