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尿酸与散发性肌萎缩侧索硬化症患者生存的性别特异性关联。

Gender-specific association of uric acid and survival in sporadic amyotrophic lateral sclerosis patients.

机构信息

College of Medicine, Nankai University, Tianjin, China; Medical School of Chinese PLA, Beijing, China.

Department of Neurology, the First Medical Center, Chinese PLA General Hospital, Beijing, China.

出版信息

Brain Res. 2023 Sep 15;1815:148445. doi: 10.1016/j.brainres.2023.148445. Epub 2023 Jun 7.

Abstract

OBJECTIVE

To investigate the relationship between serum uric acid (UA) and survival in sporadic amyotrophic lateral sclerosis (sALS) patients.

METHOD

A total of 801 sporadic amyotrophic lateral sclerosis (sALS) patients fulfilled the revised El Escorial criteria were enrolled and followed up in the study. Baseline clinical data and laboratory variables including gender, age, age of onset, site of onset, disease duration, body mass index (BMI), uric acid (UA), creatinine (Cr), and creatine kinase (CK) were collected during enrollment. Multivariate Cox regression models were used to evaluate the survival-related factors after adjustment for confounders.

RESULTS

The serum UA level was significantly lower in female patients than that in male patients (243.5 vs 314.9 μmol/L, p < 0.001). Gender, BMI, Cr, CK were significantly associated with the level of uric acid according to the linear regression analysis. In the multivariate Cox regression analysis, higher serum UA level (>268.0 μmol/L) was an independent protective factor for prolonged survival among female patients (HR = 0.69, P = 0.042) after adjustment for confounders.

CONCLUSION

The present study provided further support that higher UA was a protective factor for survival in sALS patients, especially in female.

摘要

目的

研究血清尿酸(UA)与散发性肌萎缩侧索硬化症(sALS)患者生存的关系。

方法

本研究共纳入 801 例符合修订后的埃尔埃斯科里亚尔标准的散发性肌萎缩侧索硬化症(sALS)患者,并进行了随访。在入组时收集了基线临床数据和实验室变量,包括性别、年龄、发病年龄、发病部位、病程、体重指数(BMI)、尿酸(UA)、肌酐(Cr)和肌酸激酶(CK)。采用多变量 Cox 回归模型,在调整混杂因素后评估与生存相关的因素。

结果

女性患者的血清 UA 水平明显低于男性患者(243.5 与 314.9 μmol/L,p < 0.001)。根据线性回归分析,性别、BMI、Cr、CK 与尿酸水平显著相关。在多变量 Cox 回归分析中,校正混杂因素后,较高的血清 UA 水平(>268.0 μmol/L)是女性患者生存时间延长的独立保护因素(HR=0.69,P=0.042)。

结论

本研究进一步支持了较高的 UA 是 sALS 患者生存的保护因素,尤其是在女性中。

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