不同肥胖表型的血清尿酸水平与颈动脉粥样硬化的超声特征

Serum Urate Levels and Ultrasound Characteristics of Carotid Atherosclerosis across Obesity Phenotypes.

作者信息

Efremova Daniela, Ciobanu Natalia, Glavan Danu, Leahu Pavel, Racila Renata, Bălănuță Tatiana, Matei Alexandru, Vasilieva Maria, Cheptea Cristina, Bîtcă Paula, Damian Cristina, Bondarciuc Ana, Bejenari Irina, Cojocaru Adelina, Manea Diana, Ciocanu Mihail, Zota Eremei, Ciolac Dumitru, Groppa Stanislav A

机构信息

Department of Neurology, Institute of Emergency Medicine, 2004 Chisinau, Moldova.

Department of Neurology, Nicolae Testemitanu State University of Medicine and Pharmacy, 2004 Chisinau, Moldova.

出版信息

Biomedicines. 2023 Jul 4;11(7):1897. doi: 10.3390/biomedicines11071897.

DOI:10.3390/biomedicines11071897

PMID:37509536

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10376805/

Abstract

BACKGROUND

Existing evidence suggests a close link among high levels of serum urate (SU), obesity and carotid atherosclerosis. The aim of the present study was to evaluate the interrelations between SU levels and carotid atherosclerosis in subjects with different obesity phenotypes.

METHODS

In this study, a total of 2076 subjects (mean age 48.1 ± 13.1 years; 1307 women) were recruited: 59 with general obesity, 616 with central obesity, 715 with mixed (general-central) obesity and 686 non-obese. Anthropometric measurements, vascular risk factors, blood biochemistry analysis (including SU levels), and carotid ultrasound were performed. Ultrasound assessment included evaluation of intima-media thickness (IMT) and plaque characteristics, including number, total area and type (vulnerable vs. stable) of plaques.

RESULTS

After adjustment for potential confounders, the highest levels of SU were observed in subjects with mixed obesity, followed by subjects with central obesity, general obesity and the non-obese (309.4 ± 82.2 vs. 301.2 ± 73.1 vs. 272.9 ± 61.8 vs. 234.2 ± 59.8 μmol/L, respectively; F = 149.2, post hoc < 0.001). Similarly, subjects with mixed and central obesity presented higher values of IMT compared to subjects with general obesity and the non-obese (0.68 ± 0.16 vs. 0.67 ± 0.16 vs. 0.62 ± 0.14 vs. 0.57 ± 0.13 mm, respectively; F = 54.2, post hoc < 0.001). No difference in number, total area and type of plaques among obesity groups were attested (all > 0.05). Significantly higher IMT values were observed in subjects with increased SU levels compared to subjects with normal SU levels (0.70 ± 0.10 vs. 0.62 ± 0.14 mm, = 0.02) only within the central obesity group. Increasing levels of SU were associated with a higher frequency of increased IMT only in subjects with central obesity (OR 1.033, 95% CI 1.025-1.041). Similarly, SU levels yielded a satisfactory performance in detecting subjects with increased IMT (AUC 0.65, 95% CI 0.50-0.73, subjects with carotid plaques (0.62, 95% CI 0.55-0.68) and subjects with vulnerable plaque types (0.68, 0.59-0.76) only within the central obesity group.

CONCLUSIONS

Among the studied obesity types, the association between SU levels and markers of carotid atherosclerosis was of particular significance in subjects with central obesity.

摘要

背景

现有证据表明，高血清尿酸（SU）水平、肥胖与颈动脉粥样硬化之间存在密切联系。本研究旨在评估不同肥胖表型受试者中SU水平与颈动脉粥样硬化之间的相互关系。

方法

本研究共招募了2076名受试者（平均年龄48.1±13.1岁；女性1307名）：59名全身肥胖者、616名中心性肥胖者、715名混合性（全身-中心性）肥胖者和686名非肥胖者。进行了人体测量、血管危险因素评估、血液生化分析（包括SU水平）以及颈动脉超声检查。超声评估包括对内膜中层厚度（IMT）和斑块特征的评估，包括斑块数量、总面积和类型（易损型与稳定型）。

结果

在对潜在混杂因素进行校正后，混合性肥胖受试者的SU水平最高，其次是中心性肥胖受试者、全身肥胖受试者和非肥胖受试者（分别为309.4±82.2 vs. 301.2±73.1 vs. 272.9±61.8 vs. 234.2±59.8 μmol/L；F = 149.2，事后检验<0.001）。同样，与全身肥胖受试者和非肥胖受试者相比，混合性和中心性肥胖受试者的IMT值更高（分别为0.68±0.16 vs. 0.67±0.16 vs. 0.62±0.14 vs. 0.57±0.13 mm；F = 54.2，事后检验<0.001）。肥胖组之间在斑块数量、总面积和类型方面未证实存在差异（均>0.05）。仅在中心性肥胖组中，SU水平升高的受试者的IMT值显著高于SU水平正常的受试者（0.70±0.10 vs. 0.62±0.14 mm，P = 0.02）。仅在中心性肥胖受试者中，SU水平升高与IMT增加的频率较高相关（OR 1.033，95%CI 1.025-1.041）。同样，仅在中心性肥胖组中，SU水平在检测IMT增加的受试者（AUC 0.65，95%CI 0.50-0.73）、有颈动脉斑块的受试者（0.62，95%CI 0.55-0.68）和有易损斑块类型的受试者（0.68，0.59-0.76）方面表现良好。