Department of Clinical Nutrition and Metabolism, Affiliated Zhongshan Hospital of Dalian University, Dalian, China.
Department of Prevention and Healthcare, Affiliated Zhongshan Hospital of Dalian University, Dalian, China.
Nutr Metab Cardiovasc Dis. 2023 May;33(5):1066-1076. doi: 10.1016/j.numecd.2023.02.025. Epub 2023 Mar 2.
Serum uric acid (SUA) is involved in the development of cardiovascular disease (CVD). However, information on the dose-response relationship between SUA and CVD is limited in the Chinese population. This study aimed to investigate the potential nonlinear dose-response association of SUA with CVD risk in a Chinese population and to explore the effect of sex on these associations.
Cross-sectional data, from 6252 Chinese adults aged 30-74 years who participated in the China Health and Nutrition Survey 2009, were stratified by SUA deciles. The 10-year risk of CVD was determined using the Framingham risk score. A restricted cubic spline (RCS) was incorporated into the logistic models to assess the nonlinear relationship between SUA and CVD. Among the participants, 65%, 20%, and 15% had low, moderate, and high 10-year CVD risks, respectively. Compared with the reference SUA strata of 225 to <249 μmol/L, CVD risk was significantly increased at SUA ≥294 μmol/L, with adjusted ORs ranging from 2.39 (1.33-4.33) to 4.25 (2.37-7.65). An increasingly higher nonsignificant CVD risk was found at SUA <225 μmol/L and showed a nonlinear U-shaped association. In the fitted RCS model, an approximate U-shaped association between SUA and CVD risk scores was found in women, but this significant nonlinear relationship was not found in men.
This study showed that both lower and higher SUA levels were associated with a higher 10-year CVD risk among Chinese adults, forming a U-shaped relationship, and this pattern was particularly pronounced for women.
血清尿酸（SUA）与心血管疾病（CVD）的发生有关。然而，在中国人群中，SUA 与 CVD 风险之间的剂量-反应关系的信息有限。本研究旨在探讨 SUA 与 CVD 风险之间在中国人群中的潜在非线性剂量-反应关系，并探讨性别对这些关系的影响。
本研究对 6252 名年龄在 30-74 岁之间的中国成年人进行了横断面数据分析，这些成年人参加了 2009 年中国健康与营养调查。根据 SUA 十分位数分层。使用 Framingham 风险评分确定 CVD 的 10 年风险。采用限制性立方样条（RCS）纳入逻辑模型，评估 SUA 与 CVD 之间的非线性关系。在参与者中，65%、20%和 15%分别有低、中和高的 10 年 CVD 风险。与 225 至<249 μmol/L 的参考 SUA 分层相比，SUA ≥294 μmol/L 时 CVD 风险显著增加，调整后的 OR 范围为 2.39（1.33-4.33）至 4.25（2.37-7.65）。在 SUA <225 μmol/L 时，发现 CVD 风险呈逐渐升高但无统计学意义，呈现出非线性 U 型关联。在拟合的 RCS 模型中，女性 SUA 与 CVD 风险评分之间存在近似的 U 型关联，但在男性中未发现这种显著的非线性关系。
本研究表明，中国成年人中较低和较高的 SUA 水平均与较高的 10 年 CVD 风险相关，形成 U 型关系，且这种模式在女性中尤为明显。
