Departamento de Cardiologia, Universidade de Ciências da Saúde, Van Training and Education Hospital, Van - Turquia.
Departamento de Cardiologia, Universidade de Ciências da Saúde, Sultan II. Abdulhamid Han Training and Research Hospital, Istanbul - Turquia.
Arq Bras Cardiol. 2023 Mar;120(5):e20220819. doi: 10.36660/abc.20220819.
Hypertension causes subendothelial inflammation and dysfunction in resulting atherosclerosis. Carotid intima-media thickness (CIMT) is a useful marker of endothelial dysfunction and atherosclerosis. The uric acid to albumin ratio (UAR) has emerged as a novel marker for predicting cardiovascular events.
We aimed to investigate the association of UAR with CIMT in hypertensive patients.
Two hundred sixteen consecutive hypertensive patients were enrolled in this prospective study. All patients underwent carotid ultrasonography to classify low (CIMT < 0.9 mm) and high (CIMT ≥ 0.9 mm) CIMT groups. The predictive ability of UAR for high CIMT was compared with systemic immune inflammation index (SII), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and C-reactive protein/albumin ratio (CAR). A two-sided p-value <0.05 was accepted as statistically significant.
Patients with high CIMT were older and had higher UAR, SII, NLR, and CAR than low CIMT. Age, UAR, SII, NLR, and CAR, but not PLR, were associated with high CIMT. In multivariable analysis, age, CRP, SII, and UAR were independent predictors of high CIMT. The discrimination ability of UAR was higher than uric acid, albumin, SII, NLR, and CAR, and UAR had a higher model fit than those variables. UAR had higher additive improvement in detecting high CIMT than other variables, as assessed with net-reclassification improvement, IDI, and C-statistics. UAR was also significantly correlated with CIMT.
UAR might be used to predict high CIMT and might be useful for risk stratification in hypertensive patients.
高血压导致动脉粥样硬化的血管内皮炎症和功能障碍。颈动脉内膜中层厚度（CIMT）是内皮功能障碍和动脉粥样硬化的有用标志物。尿酸与白蛋白比值（UAR）已成为预测心血管事件的新型标志物。
我们旨在研究 UAR 与高血压患者 CIMT 的相关性。
本前瞻性研究纳入了 216 例连续高血压患者。所有患者均接受颈动脉超声检查，以将 CIMT 分为低（CIMT＜0.9mm）和高（CIMT≥0.9mm）组。比较 UAR 与全身免疫炎症指数（SII）、中性粒细胞/淋巴细胞比值（NLR）、血小板/淋巴细胞比值（PLR）和 C 反应蛋白/白蛋白比值（CAR）对高 CIMT 的预测能力。双侧 p 值＜0.05 被认为具有统计学意义。
高 CIMT 组患者年龄较大，UAR、SII、NLR 和 CAR 均高于低 CIMT 组。年龄、UAR、SII、NLR 和 CAR 与高 CIMT 相关，而 PLR 与高 CIMT 无关。多变量分析显示，年龄、CRP、SII 和 UAR 是高 CIMT 的独立预测因素。与尿酸、白蛋白、SII、NLR 和 CAR 相比，UAR 对高 CIMT 的判别能力更高，且 UAR 的模型拟合度也更高。UAR 在检测高 CIMT 方面的附加改善作用高于其他变量，评估指标包括净重新分类改善、IDI 和 C 统计量。UAR 与 CIMT 显著相关。
UAR 可用于预测高 CIMT，可能有助于高血压患者的风险分层。
