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血清尿酸、夜间高血压与高危妊娠子痫前期风险的关系。

Relationship between serum uric acid, nocturnal hypertension and risk for preeclampsia in high-risk pregnancies.

机构信息

Unidad de Enfermedades Cardiometabólicas, Servicio de Clínica Médica, Hospital Gral. San Martín, La Plata, Argentina.

Facultad de Ciencias Médicas, UNLP, La Plata, Argentina.

出版信息

J Hum Hypertens. 2024 Sep;38(9):642-648. doi: 10.1038/s41371-024-00939-w. Epub 2024 Jul 23.

Abstract

To analyze the possible association between serum uric acid (SUA) and nocturnal hypertension and to evaluate the ability of these variables (alone or in combination) to predict preeclampsia (PE) we conducted a historical cohort study in 532 high-risk pregnancies. Women were divided according to SUA values and nocturnal blood pressure (BP) into four groups: 1- normal SUA and nocturnal normotension; 2- high SUA and nocturnal normotension; 3- normal SUA and nocturnal hypertension and 4- high SUA and nocturnal hypertension. High SUA was defined by the top quartile values and nocturnal hypertension as BP ≥ 120/70 mmHg, using ambulatory blood pressure monitoring (ABPM), during nocturnal rest. Risks for PE were compared using logistic regression. SUA had a weak but significant correlation with daytime systolic ABPM (r = 0.11, p = 0.014), daytime diastolic ABPM (r = 0.13, p = 0.004), nighttime systolic ABPM (r = 0.16, p < 0.001) and nighttime diastolic ABPM (r = 0.18, p < 0.001). Also, all ABPM values were higher in women with high SUA. The absolute risk of PE increased through groups: 6.5%, 13.1%, 31.2%, and 47.9% for groups 1, 2, 3, and 4, respectively, p < 0.001. Compared with Group 1, Group 3 (OR 6.29 95%CI 3.41-11.60), but not Group 2 (OR 2.15 95%CI 0.88-5.24), had statistically significant higher risk for PE. Group 4 (women with both, high SUA and nocturnal hypertension) had the highest risk (OR 13.11 95%CI 6.69-25.70). Risks remained statistically significant after the adjustment for relevant variables. In conclusion, the combination of SUA > 4 mg/dL and nocturnal BP > 120/70 mmHg implies a very high risk to developed PE.

摘要

为了分析血清尿酸(SUA)与夜间高血压之间可能存在的关联,并评估这些变量(单独或联合)预测子痫前期(PE)的能力,我们对 532 例高危妊娠进行了一项历史性队列研究。根据 SUA 值和夜间血压(BP)将女性分为四组:1-正常 SUA 和夜间正常血压;2-高 SUA 和夜间正常血压;3-正常 SUA 和夜间高血压;4-高 SUA 和夜间高血压。高 SUA 定义为四分位值最高,夜间高血压定义为使用动态血压监测(ABPM)夜间休息时 BP≥120/70mmHg。使用逻辑回归比较 PE 风险。SUA 与日间收缩压 ABPM(r=0.11,p=0.014)、日间舒张压 ABPM(r=0.13,p=0.004)、夜间收缩压 ABPM(r=0.16,p<0.001)和夜间舒张压 ABPM(r=0.18,p<0.001)呈弱但有统计学意义的相关性。此外,SUA 较高的女性所有 ABPM 值均较高。PE 的绝对风险随着组别的增加而增加:1 组、2 组、3 组和 4 组分别为 6.5%、13.1%、31.2%和 47.9%,p<0.001。与 1 组相比,3 组(OR 6.29 95%CI 3.41-11.60),而不是 2 组(OR 2.15 95%CI 0.88-5.24),PE 的风险显著增加。同时存在高 SUA 和夜间高血压的 4 组(OR 13.11 95%CI 6.69-25.70)风险最高。在调整相关变量后,风险仍然具有统计学意义。总之,SUA>4mg/dL 和夜间 BP>120/70mmHg 的组合提示发生 PE 的风险非常高。

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