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在一项大型台湾人群随访研究中,高尿酸血症与新发慢性肾脏病之间的关联存在性别差异。

Sex Difference in the Associations among Hyperuricemia with New-Onset Chronic Kidney Disease in a Large Taiwanese Population Follow-Up Study.

机构信息

Department of Nursing, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan.

Department of Occupational Safety and Health, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan.

出版信息

Nutrients. 2022 Sep 16;14(18):3832. doi: 10.3390/nu14183832.

Abstract

The global prevalence and incidence of chronic kidney disease (CKD) continue to increase. Whether hyperuricemia is an independent risk factor for renal progression and whether there are sex differences in the relationships between serum uric acid (UA) and a decline in renal function are unclear. Therefore, in this longitudinal study, we aimed to explore these relationships in a large cohort of around 27,000 Taiwanese participants in the Taiwan Biobank (TWB), and also to identify serum UA cutoff levels in men and women to predict new-onset CKD. A total of 26,942 participants with a median 4 years of complete follow-up data were enrolled from the TWB. We excluded those with CKD (estimated glomerular filtration rate <60 mL/min/1.73 m2) at baseline (n = 297), and the remaining 26,645 participants (males: 9356; females: 17,289) were analyzed. The participants who developed CKD during follow-up were defined as having incident new-onset CKD, and those with a serum UA level >7 mg/dL in males and >6 mg/dL in females were classified as having hyperuricemia. After multivariable analysis, hyperuricemia (odds ratio [OR], 2.541; 95% confidence interval [CI], 1.970−3.276; p < 0.001) was significantly associated with new-onset CKD. Furthermore, in the male participants (n = 9356), hyperuricemia (OR, 1.989; 95% CI, 1.440−2.747; p < 0.001), and quartile 4 of UA (vs. quartile 1; OR, 2.279; 95% CI, 1.464−3.547; p < 0.001) were significantly associated with new-onset CKD, while in the female participants (n = 17,289), hyperuricemia (OR, 3.813; 95% CI, 2.500−5.815; p < 0.001), quartile 3 of UA (vs. quartile 1; OR, 3.741; 95% CI, 1.250−11.915; p = 0.018), and quartile 4 of UA (vs. quartile 1; OR, 12.114; 95% CI, 14.278−34.305; p < 0.001) were significantly associated with new-onset CKD. There were significant interactions between hyperuricemia and sex (p = 0.024), and quartiles of serum UA and sex (p = 0.010) on new-onset CKD. Hyperuricemia was associated with new-onset CKD in the enrolled participants, and the interactions between hyperuricemia and sex were statistically significant. Hyperuricemia was more strongly associated with new-onset CKD in the women than in the men.

摘要

全球慢性肾脏病(CKD)的患病率和发病率持续上升。高尿酸血症是否是肾脏进展的独立危险因素,以及血清尿酸(UA)与肾功能下降之间的关系是否存在性别差异尚不清楚。因此,在这项对大约 27000 名台湾生物库(TWB)参与者的大型队列进行的纵向研究中,我们旨在探讨这些关系,并确定男性和女性中预测新发 CKD 的血清 UA 临界值。共纳入来自 TWB 的 26942 名中位随访时间为 4 年的参与者。我们排除了基线时患有 CKD(估计肾小球滤过率 <60 mL/min/1.73 m2)的患者(n=297),其余 26645 名参与者(男性:9356;女性:17289)被纳入分析。随访期间发生 CKD 的患者被定义为患有新发 CKD,血清 UA 水平男性>7 mg/dL 且女性>6 mg/dL 的患者被归类为高尿酸血症。多变量分析后,高尿酸血症(比值比[OR],2.541;95%置信区间[CI],1.970-3.276;p<0.001)与新发 CKD 显著相关。此外,在男性参与者(n=9356)中,高尿酸血症(OR,1.989;95%CI,1.440-2.747;p<0.001)和 UA 第 4 四分位数(与第 1 四分位数相比;OR,2.279;95%CI,1.464-3.547;p<0.001)与新发 CKD 显著相关,而在女性参与者(n=17289)中,高尿酸血症(OR,3.813;95%CI,2.500-5.815;p<0.001)、UA 第 3 四分位数(与第 1 四分位数相比;OR,3.741;95%CI,1.250-11.915;p=0.018)和 UA 第 4 四分位数(与第 1 四分位数相比;OR,12.114;95%CI,14.278-34.305;p<0.001)与新发 CKD 显著相关。高尿酸血症与性别(p=0.024)以及血清 UA 四分位数与性别(p=0.010)之间存在显著的交互作用与新发 CKD。高尿酸血症与参与者的新发 CKD 相关,高尿酸血症与性别的交互作用具有统计学意义。高尿酸血症与新发 CKD 的相关性在女性中比男性更强。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cc1f/9501113/77a76559a858/nutrients-14-03832-g001.jpg

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