Internal Medicine and Nephrology Division, Department of Life, Health & Environmental Sciences, San Salvatore Hospital, University of L'Aquila, ASL 1 Avezzano-Sulmona-L'Aquila, 67100 L'Aquila, Italy.
Nutrients. 2023 Mar 23;15(7):1563. doi: 10.3390/nu15071563.
(1) Background: Uric acid is a well-known cardiovascular (CV) risk factor in the general population but its role in the setting of rheumatic diseases other than gout is unclear. (2) Methods: This is a retrospective study investigating a cohort of 105 pSS patients recording clinical, serological, and CV-related variables including adherence to the Mediterranean diet. (3) Results: We observed a strong relationship between disease activity, interstitial lung disease (ILD), and CV events. The association between ILD and CV events was dependent on higher SUA levels but independent of other traditional CV risk factors. All three cases of previous non-fatal stroke were reported by females aged <65 years, with higher SUA levels, and two of them also had pSS-ILD. Forty (38%) patients had a 10-year risk of fatal and non-fatal CV disease events beyond the cut-off recommended for their age, and using the correction factor of 1.5 currently applied only to rheumatoid arthritis, we could better identify patient subsets characterized by different CV risk profiles including different SUA levels. (4) Conclusions: This study is the first to investigate in depth the role of SUA in the CV scenario of pSS. Our findings underpin the importance of assessing SUA levels in pSS in addition to the other traditional CV risk factors and to consider applying the correction factor for CV risk assessment tools to achieve a better stratification of CV risk.
(1) 背景：尿酸是普通人群中众所周知的心血管（CV）危险因素，但在除痛风以外的风湿性疾病中其作用尚不清楚。(2) 方法：这是一项回顾性研究，调查了 105 例 pSS 患者的队列，记录了临床、血清学和与 CV 相关的变量，包括对地中海饮食的依从性。(3) 结果：我们观察到疾病活动度、间质性肺病（ILD）和 CV 事件之间存在很强的相关性。ILD 和 CV 事件之间的关联取决于更高的 SUA 水平，但独立于其他传统的 CV 危险因素。以前非致命性中风的三个病例均由年龄<65 岁、SUA 水平较高的女性报告，其中两人还患有 pSS-ILD。40（38%）例患者的致命和非致命 CV 疾病事件的 10 年风险超过了为其年龄推荐的截止值，并且仅适用于类风湿关节炎的 1.5 倍校正因子，我们可以更好地识别具有不同 CV 风险特征的患者亚组，包括不同的 SUA 水平。(4) 结论：这项研究首次深入探讨了 SUA 在 pSS 的 CV 情况下的作用。我们的研究结果强调了在评估 pSS 患者的 SUA 水平以及其他传统的 CV 危险因素的同时，评估 SUA 水平的重要性，并考虑应用 CV 风险评估工具的校正因子，以更好地分层 CV 风险。
