Division of Rheumatology, NYU Grossman School of Medicine, New York, NY, USA.
Department of Veterans Affairs Rheumatology Section, New York Harbor Health Care System, New York Campus of the U.S., New York, NY, USA.
Curr Rheumatol Rep. 2023 May;25(5):83-97. doi: 10.1007/s11926-023-01100-1.
To discuss what is currently known about the association and potential mechanistic interactions of hyperuricemia and gout with peripheral arterial disease (PAD).
Gout patients are at increased risk for coronary artery disease, but less is known about their risk for PAD. Studies suggest that the presence of gout and hyperuricemia are associated with PAD independent of known established risk factors. Moreover, higher SU was found to be associated with greater odds of having PAD and was independently associated with decreased absolute claudication distance. Urate's role in free radical formation, platelet aggregation, vascular smooth muscle proliferation, and impaired endothelial vasodilation may promote atherosclerotic progression. Studies suggest that patients with hyperuricemia or gout are at higher risk for developing PAD. Evidence is stronger for the relationship between elevated SU and PAD than for gout and PAD, but more data is needed. Whether elevated SU serves as a marker or cause of PAD remains to be investigated.
探讨高尿酸血症和痛风与外周动脉疾病(PAD)的关联及潜在的机制相互作用。
痛风患者患冠状动脉疾病的风险增加,但对其患 PAD 的风险知之甚少。研究表明,痛风和高尿酸血症的存在与 PAD 相关,且独立于已知的既定危险因素。此外,SU 水平越高,患 PAD 的几率越大,且与绝对跛行距离减小独立相关。尿酸在自由基形成、血小板聚集、血管平滑肌增殖和内皮血管舒张功能障碍中的作用可能促进动脉粥样硬化的进展。研究表明,高尿酸血症或痛风患者患 PAD 的风险更高。SU 升高与 PAD 之间的关系证据比痛风与 PAD 之间的关系更有力,但需要更多的数据。SU 升高是 PAD 的标志物还是病因仍有待研究。