根据目标范围内的危险因素数量，高尿酸血症与心血管疾病风险的关联。

Association of hyperuricemia with risk of cardiovascular disease according to the number of risk factors within target range.

机构信息

Department of Cardiology, Tangshan People's Hospital, North China University of Science and Technology, Tangshan, China.

Department of Epidemiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China; Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.

出版信息

Nutr Metab Cardiovasc Dis. 2024 Nov;34(11):2489-2497. doi: 10.1016/j.numecd.2024.07.011. Epub 2024 Jul 21.

DOI:10.1016/j.numecd.2024.07.011

PMID:39174429

Abstract

BACKGROUND AND AIMS

Risk factor modification may decrease the risk of cardiovascular disease (CVD). Whether risk factor modification can mitigate the effect of hyperuricemia on CVD is unclear. This study aimed to investigate the risk of CVD among individuals with hyperuricemia, according to risk factors on target, compared with controls without hyperuricemia.

METHODS AND RESULTS

This prospective study included 91,722 participants free of CVD at baseline (2006-2007) of the Kailuan study. Individuals with hyperuricemia were categorized according to the number of seven selected risk factors within the guideline-recommended target range (nonsmoking, physical activity, healthy diet, guideline-recommended levels of body mass index, blood pressure, fasting blood glucose, and total cholesterol). During a median follow-up of 13.00 years, 671 out of 6740 individuals (9.96%) with hyperuricemia and 6301 out of 84,982 control subjects (7.41%) had incident CVD. Compared with control subjects without hyperuricemia, individuals with hyperuricemia who had 4 or 5 to 7 risk factors on target had no significant excess CVD risk, the hazard ratio (HR) (95% confidence internal [CI]) was 0.93 (0.79-1.10) and 0.88 (0.71-1.10), respectively. Among individuals with hyperuricemia, excess CVD risk decreased stepwise for a higher number of risk factors on target, the HR of CVD associated with per additional risk factor within target range was 0.82 (95% CI, 0.77-0.87). Similar results were yielded for CVD subtypes.

CONCLUSIONS

Among individuals with hyperuricemia, excess CVD risk decreased stepwise for a higher number of risk factors within target.

摘要

背景与目的

危险因素的改变可能降低心血管疾病（CVD）的风险。危险因素的改变是否可以减轻高尿酸血症对 CVD 的影响尚不清楚。本研究旨在根据目标范围内的七种选定危险因素的数量，调查高尿酸血症个体发生 CVD 的风险，与无高尿酸血症的对照者比较。

方法和结果

本前瞻性研究纳入了 91722 名基线（2006-2007 年）无 CVD 的开滦研究参与者。根据指南推荐的目标范围内（不吸烟、身体活动、健康饮食、指南推荐的体重指数、血压、空腹血糖和总胆固醇）的七种选定危险因素的数量，将高尿酸血症个体进行分类。在中位随访 13.00 年期间，6740 名高尿酸血症患者中有 671 名（9.96%）和 84982 名对照者中有 6301 名（7.41%）发生了 CVD。与无高尿酸血症的对照者相比，有 4 个或 5 至 7 个目标危险因素的高尿酸血症患者发生 CVD 的风险没有显著增加，风险比（HR）（95%置信区间）为 0.93（0.79-1.10）和 0.88（0.71-1.10）。在高尿酸血症患者中，随着目标范围内危险因素数量的增加，CVD 风险呈逐步下降趋势，与目标范围内每增加一个危险因素相关的 CVD 风险 HR 为 0.82（95%CI，0.77-0.87）。对于 CVD 亚型也得到了类似的结果。