Huang Yating, Li Jie, Sun Feifei, Zhou Huining, Jiang Hua, Chen Liang
Department of Cardiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China.
Department of Cardiology, Ruijin-Hainan Hospital Shanghai Jiao Tong University School of Medicine (Hainan Boao Research Hospital), Qionghai, China.
Sci Rep. 2025 Jan 2;15(1):97. doi: 10.1038/s41598-024-83831-4.
A correlation between UA levels and the development of hypertension has been demonstrated. However, the relationship between UA and all-cause mortality in patients with hypertension remains underexplored. A nonlinear association between UA and all-cause mortality across sexes was observed through smoothed curve fitting. The correlation between UA and all-cause mortality was calculated by threshold and saturation effect analysis, along with Cox regression models. The stability of the results in the presence of different comorbidities was verified through stratified analysis for interaction testing. Smoothed curve fitting was also used to examine the association between UA and various diseases. The association between UA and all-cause mortality in patients with hypertension exhibited a U-shaped curve, with inconsistent inflection points between the sexes. In male patients with hypertension, all-cause mortality gradually decreased with increasing UA levels when UA levels were ≤ 7.2 mg/dL (HR 0.975; 95% CI 0.929-1.024) and gradually increased with increasing UA levels when UA levels were > 7.2 mg/dL (HR 1.204; 95% CI 1.120-1.294). Similar findings were observed in female patients with hypertension, with UA as a protective factor when UA levels were ≤ 5.1 mg/dL (HR 0.902; 95% CI 0.820-0.991) and a risk factor when UA levels were > 5.1 mg/dL (HR 1.120; 95% CI 1.072-1.169). The association between UA and all-cause mortality in patients with hypertension exhibits a U-shaped curve. All-cause mortality tends to decrease and then increase with increasing UA levels, with the inflection point varying between sexes.
已证实尿酸（UA）水平与高血压的发生之间存在关联。然而，高血压患者中尿酸与全因死亡率之间的关系仍未得到充分研究。通过平滑曲线拟合观察到尿酸与全因死亡率在不同性别间存在非线性关联。采用阈值和饱和效应分析以及Cox回归模型计算尿酸与全因死亡率之间的相关性。通过分层分析进行交互检验，验证了在存在不同合并症情况下结果的稳定性。平滑曲线拟合还用于研究尿酸与各种疾病之间的关联。高血压患者中尿酸与全因死亡率之间的关联呈现U形曲线，不同性别间拐点不一致。在男性高血压患者中，当尿酸水平≤7.2mg/dL时，全因死亡率随尿酸水平升高而逐渐降低（风险比[HR]0.975；95%置信区间[CI]0.929 - 1.024），当尿酸水平>7.2mg/dL时，全因死亡率随尿酸水平升高而逐渐升高（HR 1.204；95%CI 1.120 - 1.294）。在女性高血压患者中也观察到类似结果，当尿酸水平≤5.1mg/dL时，尿酸为保护因素（HR 0.902；95%CI 0.820 - 0.991），当尿酸水平>5.1mg/dL时，尿酸为危险因素（HR 1.120；95%CI 1.072 - 1.169）。高血压患者中尿酸与全因死亡率之间的关联呈现U形曲线。全因死亡率倾向于随着尿酸水平升高先降低后升高，不同性别间拐点不同。
