血清尿酸与肌酐比值是高血压患者全因死亡率的一个有用预测指标。
Serum uric acid to creatinine ratio is a useful predictor of all-cause mortality among hypertensive patients.
作者信息
Kawamoto Ryuichi, Kikuchi Asuka, Ninomiya Daisuke, Tokumoto Yoshio, Kumagi Teru
机构信息
Department of Community Medicine, Ehime University Graduate School of Medicine, Toon, Japan.
Department of Internal Medicine, Seiyo Municipal Nomura Hospital, Seiyo, Japan.
出版信息
Clin Hypertens. 2023 Apr 1;29(1):10. doi: 10.1186/s40885-023-00235-8.
BACKGROUND
Many of the existing research studies have shown that serum uric acid (SUA) is a predictor of renal disease progression. More recently, studies have suggested an association between renal function-normalized SUA and all-cause mortality in adults. This study aims to examine the association between the ratio of SUA to creatinine (SUA/Cr) and all-cause mortality with a focus on hypertensive patients.
METHODS
This study is based on 2,017 participants, of whom 916 were male (mean age, 67 ± 11 years) and 1,101 were female (mean age, 69 ± 9 years). All participants were part of the Nomura Cohort Study in 2002 (cohort 1) and 2014 (cohort 2), as well as the follow-up period (2002 follow-up rate, 94.8%; 2014 follow-up rate, 98.0%). We obtained adjusted relative risk estimates for all-cause mortality from a basic resident register. In addition, we employed a Cox proportional hazards model and adjusted it for possible confounders to determine the hazard ratio (HR) and 95% confidence interval (CI).
RESULTS
Of the total participants, 639 (31.7%) were deceased; of these, 327 (35.7%) were male and 312 (28.3%) were female. We found an independent association between a higher ratio of SUA/Cr and a higher risk of all-cause mortality in female participants only (HR, 1.10; 95% CI, 1.02-1.18). The multivariable-adjusted HRs (95% CI) for all-cause mortality across quintiles of baseline SUA/Cr were 1.28 (0.91-1.80), 1.00, 1.38 (0.95-1.98), 1.37 (0.94-2.00), and 1.57 (1.03-2.40) for male participants, and 0.92 (0.64-1.33), 1.00, 1.04 (0.72-1.50), 1.56 (1.06-2.30), and 1.59 (1.06-2.38) for female participants. When the data were further stratified on the basis of age (< 65 or ≥ 65 years), body mass index (< 22.0 or ≥ 22.0 kg/m), estimated glomerular filtration rate (< 60 or ≥ 60 mL/min/1.73 m), and presence of SUA-lowering medication, trends similar to those of the full population were found in all groups.
CONCLUSION
Baseline SUA/Cr is independently and significantly associated with future all-cause mortality among hypertensive patients.
背景
许多现有研究表明，血清尿酸（SUA）是肾脏疾病进展的一个预测指标。最近，研究表明成人中肾功能标准化的SUA与全因死亡率之间存在关联。本研究旨在探讨尿酸与肌酐比值（SUA/Cr）与全因死亡率之间的关联，重点关注高血压患者。
方法
本研究基于2017名参与者，其中916名男性（平均年龄67±11岁），1101名女性（平均年龄69±9岁）。所有参与者均为2002年（队列1）和2014年（队列2）野村队列研究的一部分，以及随访期（2002年随访率94.8%；2014年随访率98.0%）。我们从基本居民登记册中获得了全因死亡率的调整后相对风险估计值。此外，我们采用Cox比例风险模型，并对可能的混杂因素进行调整，以确定风险比（HR）和95%置信区间（CI）。
结果
在所有参与者中，639人（31.7%）死亡；其中，327人（35.7%）为男性，312人（28.3%）为女性。我们发现，仅在女性参与者中，较高的SUA/Cr比值与较高的全因死亡风险之间存在独立关联（HR，1.10；95%CI，1.02-1.18）。男性参与者基线SUA/Cr五分位数的全因死亡率多变量调整后HR（95%CI）分别为1.28（0.91-1.80）、1.00、1.38（0.95-1.98）、1.37（0.94-2.00）和1.57（1.03-2.40），女性参与者分别为0.92（0.64-1.33）、1.00、1.04（0.72-1.50）、1.56（1.06-2.30）和1.59（1.06-2.38）。当根据年龄（<65岁或≥65岁）、体重指数（<22.0或≥22.0 kg/m）、估计肾小球滤过率（<60或≥60 mL/min/1.73 m²）和使用降尿酸药物情况进一步分层数据时，所有组均发现了与总体人群相似的趋势。
结论
基线SUA/Cr与高血压患者未来的全因死亡率独立且显著相关。
Zotero 插件