School of Public Health, Hangzhou Normal University, Hangzhou, China.
School of Public Health, Hangzhou Normal University, Hangzhou, China
BMJ Open. 2023 Sep 27;13(9):e073930. doi: 10.1136/bmjopen-2023-073930.
To evaluate the associations between serum uric acid (SUA) levels and cardiovascular disease (CVD) risk factors, focusing on potential sex-specific differences.
A retrospective cohort study.
A large community-based survey was conducted every two years from 2010 to 2018 in Hangzhou, Zhejiang Province, outheastern China.
6119 participants aged 40 years and above who underwent at least three times of physical examinations were enrolled.
Participants were categorised into four groups (Q1-Q4) based on baseline SUA quartiles within the normal range, with hyperuricaemia (HUA) as the fifth group. The Q1 was the reference. By stratifying participants by gender, the relationships between SUA levels and systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (FBG) and total cholesterol (TC) were investigated using linear regression models in the generalised estimating equation. Additionally, the associations of elevated SUA levels and HUA with hypertension, hyperglycaemia and dyslipidaemia were correspondingly examined using multivariate logistic regression models.
After adjusting for confounding variables, we found positive associations between SUA levels and SBP, DBP, FBG and TC in women, and with TC in men (p<0.01). Likewise, elevated SUA quartiles and HUA were linked to increased dyslipidaemia risk in both sexes, and increased hyperglycaemia risk only in women, with HRs (95% CI) of 1.64 (1.05 to 2.55) and 2.37 (1.47 to 3.81) in the Q4 and HUA group, respectively. Women with HUA had higher hypertension risk (HR=1.45, 95% CI 1.21 to 1.73), while no such association was observed in men. Stratified analyses revealed significant associations between elevated SUA levels and CVD risk factors in postmenopausal and non-obese women.
Elevated SUA levels increase the risk of dyslipidaemia in both sexes. SUA levels within normal range and HUA are positively associated with hyperglycaemia and hypertension in postmenopausal women, but not in men.
评估血清尿酸（SUA）水平与心血管疾病（CVD）危险因素的关联，重点关注潜在的性别特异性差异。
回顾性队列研究。
在中国东部浙江省杭州市，于 2010 年至 2018 年每两年进行一次大型社区调查。
纳入了 6119 名年龄在 40 岁及以上、至少接受过 3 次体检的参与者。
根据正常范围内的基线 SUA 四分位数，将参与者分为四组（Q1-Q4），其中高尿酸血症（HUA）为第五组。Q1 为参考组。通过按性别分层参与者，使用广义估计方程中的线性回归模型，研究 SUA 水平与收缩压（SBP）、舒张压（DBP）、空腹血糖（FBG）和总胆固醇（TC）之间的关系。此外，使用多变量 logistic 回归模型分别检查了升高的 SUA 水平和 HUA 与高血压、高血糖和血脂异常的关联。
在校正混杂变量后，我们发现 SUA 水平与女性的 SBP、DBP、FBG 和 TC 以及男性的 TC 呈正相关（p<0.01）。同样，升高的 SUA 四分位数和 HUA 与两性的血脂异常风险增加有关，而仅与女性的高血糖风险增加有关，Q4 和 HUA 组的 HR（95%CI）分别为 1.64（1.05 至 2.55）和 2.37（1.47 至 3.81）。患有 HUA 的女性高血压风险更高（HR=1.45，95%置信区间 1.21 至 1.73），而男性则没有这种关联。分层分析显示，在绝经后和非肥胖女性中，升高的 SUA 水平与 CVD 危险因素之间存在显著关联。
升高的 SUA 水平会增加两性血脂异常的风险。在绝经后女性中，正常范围内的 SUA 水平和 HUA 与高血糖和高血压呈正相关，但在男性中则没有。
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