Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico.
Department of Clinical Sciences and Community Health, University of Milano.
J Hypertens. 2024 Jan 1;42(1):109-117. doi: 10.1097/HJH.0000000000003564. Epub 2023 Sep 14.
Gender-based evidence on the association between serum uric acid (SUA) and left ventricular hypertrophy (LVH), as assessed by echocardiography, is still based on single studies. Thus, we performed a systematic meta-analysis of echocardiographic studies in order to provide an updated and comprehensive information on this issue.
The PubMed, OVID-MEDLINE, and Cochrane library databases were analyzed to search English-language articles published from the inception up to March 31, 2023. Studies were identified by using MeSH terms and crossing the following search items: 'uric acid', 'hyperuricemia', 'left ventricular mass', 'left ventricular hypertrophy', 'echocardiography', 'female', 'male'.
Six studies including 2791 normotensive and hypertensive individuals were considered for the analysis. In women, increasing values of SUA were associated with progressively higher values of age, body mass index (BMI) and systolic blood pressure (SBP). This was not the case for men. In women, the meta-analysis comparing LV mass index (LVMI) in low versus high SUA group showed a greater pooled LVMI in the high SUA group [standard means difference (SMD): 0.81 ± 0. 24, confidence interval (CI) 0.34-1.27, P < 0.0001]. On the contrary, in men no statistical difference was found between the low group and high SUA group (SMD: 0.27 ± 0.27, CI: -0.27/0.81, P = 0.32).
Our meta-analysis suggests that hyperuricemia portends the likely presence of increased LVMI in women but not in men. However, as hyperuricemia in the female pooled population, different from men, was associated with older age, higher BMI and SBP, the present findings do not support an independent role of the SUA in LV remodelling process in women.
基于超声心动图评估的血清尿酸（SUA）与左心室肥厚（LVH）之间的性别证据仍然基于单项研究。因此，我们进行了一项系统的超声心动图研究荟萃分析，以便就该问题提供最新和全面的信息。
分析了 PubMed、OVID-MEDLINE 和 Cochrane 图书馆数据库，以检索自成立至 2023 年 3 月 31 日发表的英文文章。使用 MeSH 术语和交叉以下搜索项来确定研究：“尿酸”、“高尿酸血症”、“左心室质量”、“左心室肥厚”、“超声心动图”、“女性”、“男性”。
共纳入 6 项研究，包括 2791 例血压正常和高血压个体进行分析。在女性中，SUA 值的升高与年龄、体重指数（BMI）和收缩压（SBP）的逐渐升高相关。但在男性中并非如此。在女性中，比较低 SUA 组与高 SUA 组 LV 质量指数（LVMI）的荟萃分析显示，高 SUA 组的 LVMI 更高[标准均数差值（SMD）：0.81±0.24，置信区间（CI）0.34-1.27，P<0.0001]。相反，在男性中，低 SUA 组与高 SUA 组之间无统计学差异（SMD：0.27±0.27，CI：-0.27/0.81，P=0.32）。
我们的荟萃分析表明，女性的高尿酸血症预示着 LVMI 可能增加，但男性则不然。然而，由于女性血尿酸与男性不同，与年龄较大、BMI 和 SBP 较高相关，因此目前的研究结果不支持 SUA 在女性 LV 重塑过程中具有独立作用。
