Iribarren C, Folsom A R, Eckfeldt J H, McGovern P G, Nieto F J
Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis 55454-1015, USA.
Ann Epidemiol. 1996 Jul;6(4):331-40. doi: 10.1016/s1047-2797(96)00052-x.
The correlates of serum uric acid and the association of uric acid with carotid intimal-medial thickness (an early measure of atherosclerosis) were investigated in participants of the baseline examination of the Atherosclerosis Risk in Communities (ARIC) Study. The study sample included 6522 women (74% white) and 4966 men (79% white) who were aged 45 to 64 years at baseline (1986-1989). Those with prevalent coronary heart disease or previous stroke and those taking uricosuric medication were excluded. The mean (SD) uric acid concentration was 5.9 (1.5) mg/dL. It was highest among black men 45-54 years old (6.9 [1.5] mg/dL), and lowest in white women aged 45-54 years old (5.0 [1.2] mg/dL). The uric acid level was positively correlated in both sexes with a variety of health-related factors, most notably body mass index, creatinine, triglycerides, diuretic use, alcohol intake, hypertension, diabetes, and insulin levels. In a linear regression model adjusting for age and ARIC center, the level of uric acid was directly and significantly associated with B-mode ultrasound carotid intimal-medial thickness in women and white men (but not in black men). However, when known risk factors for atherosclerotic disease and relevant behavioral and biological correlates of uric acid were controlled for in multivariate analysis, the association of uric acid with this early measure of atherosclerosis became negligible in white women and much weaker and not statistically significant in black women and white men. Thus, uric acid itself may not be a risk factor for atherosclerosis. Future analysis of cardiovascular events in the ARIC Study will further elucidate the role of uric acid in atherosclerotic disease.
在社区动脉粥样硬化风险（ARIC）研究的基线检查参与者中，研究了血清尿酸的相关因素以及尿酸与颈动脉内膜中层厚度（动脉粥样硬化的早期指标）之间的关联。研究样本包括6522名女性（74%为白人）和4966名男性（79%为白人），他们在基线时（1986 - 1989年）年龄为45至64岁。排除患有冠心病或既往中风的患者以及正在服用促尿酸排泄药物的患者。尿酸浓度的均值（标准差）为5.9（1.5）mg/dL。在45 - 54岁的黑人男性中最高（6.9 [1.5] mg/dL），在45 - 54岁的白人女性中最低（5.0 [1.2] mg/dL）。尿酸水平在两性中均与多种健康相关因素呈正相关，最显著的是体重指数、肌酐、甘油三酯、利尿剂使用、酒精摄入、高血压、糖尿病和胰岛素水平。在调整年龄和ARIC中心的线性回归模型中，尿酸水平与女性和白人男性的B超颈动脉内膜中层厚度直接且显著相关（但与黑人男性无关）。然而，在多变量分析中控制了动脉粥样硬化疾病的已知危险因素以及尿酸的相关行为和生物学因素后，尿酸与这种动脉粥样硬化早期指标的关联在白人女性中变得微不足道，在黑人女性和白人男性中则变得更弱且无统计学意义。因此，尿酸本身可能不是动脉粥样硬化的危险因素。ARIC研究未来对心血管事件的分析将进一步阐明尿酸在动脉粥样硬化疾病中的作用。
