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血清尿酸是巴西成人健康纵向研究(ELSA-Brasil)中代谢综合征发病的预测生物标志物。

Serum uric acid is a predictive biomarker of incident metabolic syndrome at the Brazilian longitudinal study of adult Health (ELSA - Brasil).

机构信息

Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.

Flinders University, Adelaide, Australia.

出版信息

Diabetes Res Clin Pract. 2022 Sep;191:110046. doi: 10.1016/j.diabres.2022.110046. Epub 2022 Aug 24.

Abstract

AIM

To investigate whether serum uric acid (SUA) levels and hyperuricemia can be predictive biomarkers of incident metabolic syndrome(MS) among different body mass index(BMI) categories, and to investigate SUA cutoffs that best discriminate individuals with incident MS.

METHODS

We analyzed 7,789 participants without MS at baseline of ELSA-Brasil study. Logistic regression models were performed to evaluate associations between incident MS and SUA levels/hyperuricemia, expressed by odds ratios(ORs) and confidence intervals(95 % CI).

RESULTS

We found 1,646 incident MS cases after a median follow-up of 3.8[3.5-4.1] years. Incident MS was present among 8.3 % (n = 290) of participants with normal weight, 28.3 % (n = 850) with overweight, 39.8 % (n = 506) with obesity. Among incident MS participants of total sample, 33.0 % had hyperuricemia [SUA > 6.0 mg/dL (356.9 μmol/L)]. After all adjustments, SUA was independently prognostic of incident MS: for each 1 mg/dL increase in SUA the odds of incident MS were 45 % higher (OR1.45[CI95 %1.34-1.55 p <.01]). Associations were found for those presenting normal weight, overweight and obesity (OR1.43[CI95 %1.31-1.57 p <.01; OR1.22[CI95 %1.13-1.32 p <.01]; and OR1.16[CI95 %1.04-1.29 p <.05]) respectively. Hyperuricemia was independently associated with incident MS (OR1.88[CI95 %1.49-0.2.36 p <.01]). The SUA cut point level maximizing sensitivity and specificity in the discrimination of incident MS was 5.0 mg/dL.

CONCLUSIONS

SUA level is an independent predictive biomarker of incident MS at all BMI categories.

摘要

目的

探讨不同体质指数(BMI)类别中血清尿酸(SUA)水平和高尿酸血症是否可以作为代谢综合征(MS)发生的预测生物标志物,并探讨最佳区分发生 MS 个体的 SUA 切点。

方法

我们对 ELSA-Brasil 研究中的 7789 名基线无 MS 的参与者进行了分析。使用逻辑回归模型评估了 MS 发生与 SUA 水平/高尿酸血症之间的关联,表达为比值比(OR)和置信区间(95%CI)。

结果

在中位随访 3.8[3.5-4.1]年后,我们发现 1646 例新发 MS 病例。在正常体重(n=290)、超重(n=850)和肥胖(n=506)的参与者中,分别有 8.3%(n=290)、28.3%(n=850)和 39.8%(n=506)发生 MS。在总样本中,新发 MS 患者中有 33.0%(n=330)存在高尿酸血症[SUA>6.0mg/dL(356.9μmol/L)]。在所有调整后,SUA 与 MS 发生独立相关:SUA 每增加 1mg/dL,MS 发生的几率增加 45%(OR1.45[95%CI 1.34-1.55 p<.01])。在正常体重、超重和肥胖的参与者中均发现了这种关联(OR1.43[95%CI 1.31-1.57 p<.01;OR1.22[95%CI 1.13-1.32 p<.01];和 OR1.16[95%CI 1.04-1.29 p<.05])。高尿酸血症与 MS 发生独立相关(OR1.88[95%CI 1.49-0.236 p<.01])。在区分 MS 发生方面,SUA 切点水平最大化了灵敏度和特异性的水平为 5.0mg/dL。

结论

SUA 水平是所有 BMI 类别中 MS 发生的独立预测生物标志物。

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