The Second School of Clinical Medicine, Southern Medical University, Guangzhou 510515, Guangdong, China; Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong, China.
Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, Guangdong, China.
Nutr Metab Cardiovasc Dis. 2022 Jul;32(7):1661-1669. doi: 10.1016/j.numecd.2022.03.026. Epub 2022 Apr 2.
Uric acid (UA) and high-density lipoprotein cholesterol (HDL-C) are positively and negatively associated with atherosclerosis, respectively. UA and HDL-C are involved in the balance of proinflammatory and anti-inflammatory processes in atherosclerosis. However, it is still unclear whether UA affects the effect of HDL-C on atherosclerosis.
In this retrospective study, we enrolled 1437 patients with multiple risk factors for atherosclerosis. Patients were categorized into two groups according to their baseline UA level. Multivariate logistic regression analysis and restricted cubic spline curves were used to assess the relationship between HDL-C and carotid atherosclerosis (abnormal carotid intima-media thickness [cIMT] and carotid artery plaque) at different UA levels. Compared to patients with normouricemia, patients with hyperuricemia were older and had a more extensive history of disease and unhealthy behavior. In the normouricemia group, multivariate-adjusted odds ratios (95% CIs) for HDL-C were 0.55 (0.33-0.92) for abnormal mean cIMT, 0.59 (0.35-1.00) for abnormal maximum cIMT, and 0.53 (0.29-0.94) for the occurrence of carotid artery plaque, while the correlation between each of these three indicators with HDL-C were not significant in those with hyperuricemia. Spline regression models yielded similar results. The effect of UA on the association between HDL-C and carotid atherosclerosis remained in the subset of patients with optimal low-density lipoprotein cholesterol.
Elevated UA marks a pre-inflammatory state and impacts the role of HDL-C on carotid atherosclerosis.
尿酸（UA）和高密度脂蛋白胆固醇（HDL-C）分别与动脉粥样硬化呈正相关和负相关。UA 和 HDL-C 参与了动脉粥样硬化中促炎和抗炎过程的平衡。然而，UA 是否影响 HDL-C 对动脉粥样硬化的作用仍不清楚。
在这项回顾性研究中，我们纳入了 1437 名具有多种动脉粥样硬化危险因素的患者。根据基线 UA 水平，患者被分为两组。多变量逻辑回归分析和限制三次样条曲线用于评估不同 UA 水平下 HDL-C 与颈动脉粥样硬化（异常颈动脉内膜中层厚度[cIMT]和颈动脉斑块）之间的关系。与正常尿酸血症患者相比，高尿酸血症患者年龄更大，且有更广泛的疾病史和不健康的行为。在正常尿酸血症组中，校正后的多变量比值比（95%CI）为：异常平均 cIMT 时为 0.55（0.33-0.92），异常最大 cIMT 时为 0.59（0.35-1.00），颈动脉斑块发生时为 0.53（0.29-0.94），而在高尿酸血症患者中，这些指标中的每一个与 HDL-C 的相关性均不显著。样条回归模型得出了相似的结果。UA 对 HDL-C 与颈动脉粥样硬化之间关联的影响在低密度脂蛋白胆固醇最佳的患者亚组中仍然存在。
UA 升高标志着炎症前状态，并影响 HDL-C 对颈动脉粥样硬化的作用。
