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探讨美国成年人新的“生命必需的 8 项指标”与高尿酸血症和痛风之间的关联。

Exploration of the association between new "Life's Essential 8" with hyperuricemia and gout among US adults.

机构信息

State Key Laboratory of Complex Severe and Rare Diseases, Department of Family Medicine & Division of General Internal Medicine, Department of Internal Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College Hospital, No. 1 Shuaifuyuan, Beijing, 100730, China.

Department of Cardiology, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases, Beijing, China.

出版信息

Qual Life Res. 2024 Dec;33(12):3351-3362. doi: 10.1007/s11136-024-03777-y. Epub 2024 Sep 21.

Abstract

BACKGROUND

Previous researches have reported the relationship between uric acid and cardiovascular disease. We aimed to investigate the association of Life's Essential 8, a recently updated measurement of cardiovascular health, with the prevalence of hyperuricemia (HUA) and gout among US adults. Additionally, we also explored the relationship between LE8 and all-cause mortality among patients with HUA or gout.

METHODS

Participants from the National Health and Nutrition Examination Survey in 2007-2016 were involved in this study. LE8 score was categorized into low, moderate, high CVH groups according to American Heart Association definitions. Multivariable logistic regression and cox regression analyses, restricted cubic spline models, subgroup analysis and sensitivity analysis were used to explore the associations.

RESULTS

A total of 23,619 adult participants were included in this study, which included 4,775 hyperuricemia patients and 1,055 gout patients. Among all participants, the overall median LE8 score was 65.62 (21.25) and the prevalence of hyperuricemia and gout of were 20.2% and 4.5%, respectively. After fully adjusted the potential confounders, participants in high CVH group had a lower prevalence of hyperuricemia and gout compared with the low CVH group, with a OR (95%CI) of 0.50 (0.39-0.63) and 0.50 (0.30-0.82), respectively. The restricted cubic spline showed a significantly inverse relationship between LE8 and hyperuricemia and gout. Similar patterns were also identified in the association between LE8 scores and all-cause mortality in HUA and gout patients.

CONCLUSIONS

Higher LE8 scores are associated with lower risk and lower all-cause mortality of HUA and gout among US adults. Adherence to optimal CVH metrics may be an appropriate prevention and management strategy for reducing the socioeconomic burden of hyperuricemia and gout.

摘要

背景

先前的研究报告了尿酸与心血管疾病之间的关系。我们旨在调查最近更新的心血管健康衡量标准“生命的基本 8 项”(Life's Essential 8,简称 LE8)与美国成年人中高尿酸血症(HUA)和痛风的患病率之间的关联。此外,我们还探讨了 LE8 与 HUA 或痛风患者全因死亡率之间的关系。

方法

本研究纳入了 2007-2016 年国家健康和营养调查的参与者。根据美国心脏协会的定义,将 LE8 评分分为低、中、高心血管健康组。采用多变量逻辑回归和 Cox 回归分析、限制三次样条模型、亚组分析和敏感性分析来探讨相关性。

结果

本研究共纳入 23619 名成年参与者,其中包括 4775 名高尿酸血症患者和 1055 名痛风患者。在所有参与者中,LE8 的总体中位数为 65.62(21.25),高尿酸血症和痛风的患病率分别为 20.2%和 4.5%。在充分调整了潜在混杂因素后,与低心血管健康组相比,高心血管健康组参与者的高尿酸血症和痛风患病率较低,比值比(95%置信区间)分别为 0.50(0.39-0.63)和 0.50(0.30-0.82)。限制三次样条模型显示 LE8 与高尿酸血症和痛风之间存在显著的负相关关系。在 HUA 和痛风患者中,LE8 评分与全因死亡率之间也存在类似的关联模式。

结论

较高的 LE8 评分与美国成年人中 HUA 和痛风的风险降低和全因死亡率降低相关。坚持最佳心血管健康指标可能是一种适当的预防和管理策略,可降低高尿酸血症和痛风的社会经济负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/067d/11599414/7273022bf0ce/11136_2024_3777_Fig1_HTML.jpg

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