Li Wei, Luo Songyuan, Lin Wenhui, Hu Xiaolu, Zhou Dan, Xu Wenmin, Zhou Yingling, Luo Jianfang, Feng Yingqing
Department of Cardiology, Guangdong Provincial People's Hospital, Zhuhai Hospital (Jinwan Central Hospital of Zhuhai), Zhuhai, China.
Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
Front Cardiovasc Med. 2024 Nov 11;11:1481872. doi: 10.3389/fcvm.2024.1481872. eCollection 2024.
Robust evidence has demonstrated that inflammation plays an important role in the occurrence and development of abdominal aortic aneurysms (AAA). The serum uric acid (UA)/high-density lipoprotein cholesterol (HDL-C) ratio (UHR) has recently been recognized as a new biomarker for evaluating inflammatory and anti-inflammatory interactions. However, whether UHR is associated with AAA remains unclear. This study aimed to explore the association between UHR and presence of AAA.
We prospectively performed a hospital-based and community-based AAA screening program using ultrasonography in 9,064 individuals at Guangdong Provincial People's Hospital and two communities in China. Logistic regression analysis was used to explore the association between UHR and presence of AAA. In addition, the restricted cubic spline (RCS) regression method was used to visually investigate the dose-response relationship between UHR and the presence of AAA. Propensity score matching (PSM) analysis was conducted to adjust for baseline variations and diminish selection bias, and subgroup analysis was performed to investigate the consistency of the conclusions.
The prevalence of AAA was 2.45% (222/9,064) in the present study. The optimal cut-off value of UHR was 17.0%, which was selected according to the receiver operator characteristic curve. The prevalence of AAA was 3.96% in the high-UHR group (UHR ≥ 17%) and 1.54% in the low-UHR group (UHR < 17%) ( < 0.001). After adjusting for other relevant clinical covariates, UHR was independently associated with the presence of AAA, either as a continuous variable (odds ratio [OR] 1.03, 95% confidence intervals [CI] 1.01-1.05, < 0.001) or as a categorical variable (OR 1.63, 95% CI 1.18-2.26, = 0.003). The RCS curve showed a nonlinear dose-response relationship between UHR and the presence of AAA. Moreover, the positive correlation between UHR and the presence of AAA remained significant after PSM and subgroup analyses.
UHR was positively associated with the presence of AAA, and there was a non-linear dose-response relationship between them. Thus, UHR may serve as a novel and reliable predictor of AAA.
有力证据表明炎症在腹主动脉瘤（AAA）的发生和发展中起重要作用。血清尿酸（UA）/高密度脂蛋白胆固醇（HDL-C）比值（UHR）最近被认为是评估炎症与抗炎相互作用的一种新生物标志物。然而，UHR是否与AAA相关仍不清楚。本研究旨在探讨UHR与AAA存在之间的关联。
我们在广东省人民医院及中国的两个社区对9064名个体前瞻性地开展了一项基于医院和社区的AAA超声筛查项目。采用逻辑回归分析探讨UHR与AAA存在之间的关联。此外，使用受限立方样条（RCS）回归方法直观研究UHR与AAA存在之间的剂量反应关系。进行倾向得分匹配（PSM）分析以调整基线差异并减少选择偏倚，并进行亚组分析以研究结论的一致性。
本研究中AAA的患病率为2.45%（222/9064）。根据受试者工作特征曲线选择UHR的最佳截断值为17.0%。高UHR组（UHR≥17%）中AAA的患病率为3.96%，低UHR组（UHR＜17%）中为1.54%（P＜0.001）。在调整其他相关临床协变量后，UHR与AAA的存在独立相关，无论是作为连续变量（比值比[OR]1.03，95%置信区间[CI]1.01 - 1.05，P＜0.001）还是作为分类变量（OR 1.63，95%CI 1.18 - 2.26，P = 0.003）。RCS曲线显示UHR与AAA的存在之间存在非线性剂量反应关系。此外，在PSM和亚组分析后，UHR与AAA存在之间的正相关仍然显著。
UHR与AAA的存在呈正相关，且它们之间存在非线性剂量反应关系。因此，UHR可能作为AAA的一种新型且可靠的预测指标。
