Tsao Hsiao-Mei, Lai Tai-Shuan, Chang Yi-Cheng, Hsiung Chia-Ni, Chou Yu-Hsiang, Wu Vin-Cent, Lin Shuei-Liong, Chen Yung-Ming
Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
Division of Nephrology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
Mayo Clin Proc. 2023 Apr;98(4):513-521. doi: 10.1016/j.mayocp.2023.01.004. Epub 2023 Mar 3.
To evaluate the association between serum urate and risk of incident chronic kidney disease (CKD) and to assess whether serum urate plays a causal role in CKD.
We conducted a prospective cohort study and Mendelian randomization analysis that analyzed longitudinal data from the Taiwan Biobank between January 1, 2012, and December 31, 2021.
A total of 34,831 individuals met the inclusion criteria, of which 4697 (13.5%) had hyperuricemia. After a median (interquartile range) follow-up of 4.1 (3.1-4.9) years, 429 participants developed CKD. After adjustment for age, sex, and comorbid conditions, each mg/dL increase in serum urate was associated with a 15% higher risk of incident CKD (HR, 1.15; 95% CI, 1.08 to 1.24; P<.001). The genetic risk score and seven Mendelian randomization methods revealed no significant association between serum urate levels and the risk of incident CKD (HR, 1.03; 95% CI, 0.72 to 1.46; P=0.89; all P>.05 for 7 Mendelian randomization methods).
This prospective, population-based cohort study showed that elevated serum urate is a significant risk factor for incident CKD; however, Mendelian randomization analyses failed to provide evidence that serum urate had a causal effect on CKD in the East Asian population.
评估血清尿酸与慢性肾脏病（CKD）发病风险之间的关联，并评估血清尿酸在CKD中是否起因果作用。
我们进行了一项前瞻性队列研究和孟德尔随机化分析，分析了2012年1月1日至2021年12月31日台湾生物银行的纵向数据。
共有34831人符合纳入标准，其中4697人（13.5%）患有高尿酸血症。在中位（四分位间距）随访4.1（3.1 - 4.9）年后，429名参与者发生了CKD。在调整年龄、性别和合并症后，血清尿酸每升高1mg/dL，CKD发病风险增加15%（HR，1.15；95%CI，1.08至1.24；P<0.001）。遗传风险评分和七种孟德尔随机化方法显示血清尿酸水平与CKD发病风险之间无显著关联（HR，1.03；95%CI，0.72至1.46；P = 0.89；七种孟德尔随机化方法的所有P>0.05）。
这项基于人群的前瞻性队列研究表明，血清尿酸升高是CKD发病的重要危险因素；然而，孟德尔随机化分析未能提供证据表明血清尿酸对东亚人群的CKD有因果作用。
