Department of Graduate School, Tianjin Medical University, Tianjin, 300051, China.
Department of Hypertension, TEDA International Cardiovascular Hospital, Tianjin, 300457, China.
BMC Cardiovasc Disord. 2023 Feb 5;23(1):68. doi: 10.1186/s12872-023-03085-2.
To estimate the relationship among uric acid (UA), 24-h microalbumin (24 h-MAU) and estimated glomerular filtration rate (eGFR) in hypertensive patients.
The study enrolled adult patients hospitalized in TEDA International Cardiovascular Hospital. The study was used to explore the correlation among UA, 24 h-MAU and eGFR. Univariate analysis was used to compare continuous or categorical data groups according to data type. Multivariate analysis was used to explore the correlation among UA, Log 24 h-MAU and eGFR by linear regression, and the relationship among UA, 24 h-MAU ≥ 30 mg/24 h (increased 24 h-MAU) and eGFR < 90 ml·min·1.73 m (mildly decreased eGFR) by logistic regression. Mediation effect analysis was used to explore the mediating effect of increased 24 h-MAU between UA and mildly decreased eGFR. Subgroup analysis was used to investigate the correlation among UA, 24 h-MAU and eGFR in different gender.
Seven hundred and thirty-three inpatients were enrolled in the study, including 257 patients with hyperuricemia. The level of UA was 377.8 ± 99.9 μmol/L in all patients enrolled, and it was about 50.1% higher in hyperuricemia group (482.3 ± 58.8 μmol/L vs. 321.4 ± 63.5 μmol/L, P < 0.001). The prevalence of hyperuricemia was 35.1% (95%CI 31.6-38.5%). The univariate regression analysis showed that UA was significant related to Log 24 h-MAU, increased 24 h-MAU, eGFR and mildly decreased eGFR. After adjusted confounding factors, UA was significant related to Log 24 h-MAU (β = 0.163, P < 0.001), eGFR (β = - 0.196, P < 0.001), increased 24 h-MAU (quantitative analysis: OR = 1.045, 95%CI 1.020-1.071, P < 0.001; qualitative analysis: OR = 2.245, 95%CI 1.410-3.572, P = 0.001), but had no significant relationship with mildly decreased eGFR. Mediating effect analysis showed that increased 24 h-MAU partially mediated the relationship between UA and mildly decreased eGFR (relative indirect effect: 25.0% and 20.3% in quantitative analysis and qualitative analysis respectively). In the subgroup analysis, the results were stable and similar to the analysis for entry patients.
The prevalence of hyperuricemia was higher in hypertensive inpatients. UA was strongly associated with Log 24 h-MAU, eGFR and increased 24 h-MAU, while the correlation with mildly decreased eGFR was affected by multiple factors. And increased 24 h-MAU might be the intermediate factor between UA and mildly decreased eGFR.
评估高血压患者尿酸（UA）、24 小时微量白蛋白（24 h-MAU）和估算肾小球滤过率（eGFR）之间的关系。
本研究纳入泰达国际心血管病医院住院的成年患者。该研究旨在探讨 UA、24 h-MAU 和 eGFR 之间的相关性。根据数据类型，使用单变量分析比较连续或分类数据组。多元线性回归分析 UA、Log 24 h-MAU 和 eGFR 之间的相关性，Logistic 回归分析 UA、24 h-MAU≥30mg/24h（增加的 24 h-MAU）和 eGFR＜90ml·min·1.73m（轻度降低的 eGFR）之间的关系。中介效应分析用于探讨增加的 24 h-MAU 在 UA 和轻度降低的 eGFR 之间的中介效应。亚组分析用于研究不同性别患者 UA、24 h-MAU 和 eGFR 之间的相关性。
本研究共纳入 733 名住院患者，其中 257 名患者患有高尿酸血症。所有患者的 UA 水平为 377.8±99.9μmol/L，高尿酸血症组的 UA 水平约高 50.1%（482.3±58.8μmol/L vs. 321.4±63.5μmol/L，P＜0.001）。高尿酸血症的患病率为 35.1%（95%CI 31.6-38.5%）。单变量回归分析显示，UA 与 Log 24 h-MAU、增加的 24 h-MAU、eGFR 和轻度降低的 eGFR 显著相关。调整混杂因素后，UA 与 Log 24 h-MAU（β=0.163，P＜0.001）、eGFR（β=-0.196，P＜0.001）、增加的 24 h-MAU（定量分析：OR=1.045，95%CI 1.020-1.071，P＜0.001；定性分析：OR=2.245，95%CI 1.410-3.572，P=0.001）显著相关，但与轻度降低的 eGFR 无显著相关性。中介效应分析显示，增加的 24 h-MAU 部分介导了 UA 与轻度降低的 eGFR 之间的关系（定量分析的相对间接效应：25.0%和定性分析的相对间接效应：20.3%）。在亚组分析中，结果稳定，与对入组患者的分析相似。
高血压住院患者高尿酸血症的患病率较高。UA 与 Log 24 h-MAU、eGFR 和增加的 24 h-MAU 密切相关，而与轻度降低的 eGFR 的相关性受多种因素影响。增加的 24 h-MAU 可能是 UA 和轻度降低的 eGFR 之间的中介因素。
