糖尿病患者死亡的血清尿酸水平阈值：心脏健康尿酸权（URRAH）项目
Serum uric acid levels threshold for mortality in diabetic individuals: The URic acid Right for heArt Health (URRAH) project.
作者信息
Masulli Maria, D'Elia Lanfranco, Angeli Fabio, Barbagallo Carlo M, Bilancio Giancarlo, Bombelli Michele, Bruno Berardino, Casiglia Edoardo, Cianci Rosario, Cicero Arrigo F G, Cirillo Massimo, Cirillo Pietro, Dell'Oro Raffaella, Desideri Giovambattista, Ferri Claudio, Gesualdo Loreto, Giannattasio Cristina, Grassi Guido, Iaccarino Guido, Lippa Luciano, Mallamaci Francesca, Maloberti Alessandro, Masi Stefano, Mazza Alberto, Mengozzi Alessandro, Muiesan Maria Lorenza, Nazzaro Pietro, Palatini Paolo, Parati Gianfranco, Pontremoli Roberto, Quarti-Trevano Fosca, Rattazzi Marcello, Reboldi Gianpaolo, Rivasi Giulia, Salvetti Massimo, Tikhonoff Valerie, Tocci Giuliano, Ungar Andrea, Verdecchia Paolo, Viazzi Francesca, Virdis Agostino, Volpe Massimo, Borghi Claudio, Galletti Ferruccio
机构信息
Department of Clinical Medicine and Surgery, 'Federico II' University of Naples, Naples, Italy.
Department of Medicine and Surgery, University of Insubria, Varese, Italy and Department of Medicine and Cardiopulmonary Rehabilitation, Maugeri Care and Research Institutes, IRCCS Tradate, Varese, Italy.
出版信息
Nutr Metab Cardiovasc Dis. 2022 May;32(5):1245-1252. doi: 10.1016/j.numecd.2022.01.028. Epub 2022 Feb 3.
BACKGROUND AND AIM
The URRAH (URic acid Right for heArt Health) Study has identified cut-off values of serum uric acid (SUA) predictive of total mortality at 4.7 mg/dl, and cardiovascular (CV) mortality at 5.6 mg/dl. Our aim was to validate these SUA thresholds in people with diabetes.
METHODS AND RESULTS
The URRAH subpopulation of people with diabetes was studied. All-cause and CV deaths were evaluated at the end of follow-up. A total of 2570 diabetic subjects were studied. During a median follow-up of 107 months, 744 deaths occurred. In the multivariate Cox regression analyses adjusted for several confounders, subjects with SUA ≥5.6 mg/dl had higher risk of total (HR: 1.23, 95%CI: 1.04-1.47) and CV mortality (HR:1.31, 95%CI:1.03-1.66), than those with SUA <5.6 mg/dl. Increased all-cause mortality risk was shown in participants with SUA ≥4.7 mg/dl vs SUA below 4.7 mg/dl, but not statistically significant after adjustment for all confounders.
CONCLUSIONS
SUA thresholds previously proposed by the URRAH study group are predictive of total and CV mortality also in people with diabetes. The threshold of 5.6 mg/dl can predict both total and CV mortality, and so is candidate to be a clinical cut-off for the definition of hyperuricemia in patients with diabetes.
背景与目的
URRAH（尿酸对心脏健康的影响）研究确定了血清尿酸（SUA）预测全因死亡率的临界值为4.7mg/dl，预测心血管（CV）死亡率的临界值为5.6mg/dl。我们的目的是在糖尿病患者中验证这些SUA阈值。
方法与结果
对URRAH研究中的糖尿病亚组人群进行了研究。在随访结束时评估全因死亡和心血管死亡情况。共研究了2570名糖尿病患者。在中位随访107个月期间，发生了744例死亡。在对多个混杂因素进行调整的多变量Cox回归分析中，SUA≥5.6mg/dl的患者全因死亡（HR：1.23，95%CI：1.04-1.47）和心血管死亡（HR：1.31，95%CI：1.03-1.66）风险高于SUA<5.6mg/dl的患者。与SUA低于4.7mg/dl的参与者相比，SUA≥4.7mg/dl的参与者全因死亡风险增加，但在对所有混杂因素进行调整后无统计学意义。
结论
URRAH研究组先前提出的SUA阈值也可预测糖尿病患者的全因死亡和心血管死亡。5.6mg/dl的阈值可预测全因死亡和心血管死亡，因此有望成为糖尿病患者高尿酸血症定义的临床临界值。
Zotero 插件