Determinants of serum uric acid levels and risk for cardiovascular disease in elderly patients

Q4 Nursing 中华临床营养杂志 Pub Date : 2018-08-30 DOI:10.3760/CMA.J.ISSN.1674-635X.2018.04.009

Shengfang Chen, Chun-li Cui, Haoming Song, Lei Lin

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Abstract

Objective To explore the determinants of serum uric acid (UA) levels and the relationship between UA and cardiovascular disease in elderly patients. Methods A cross-sectional design was used. A total of 1 066 elderly patients were consecutively recruited in the study. Anthropometric measurement and lifestyle survey were performed, and serum UA, lipid profile, glucose, homocysteine (Hcy) and superoxide dismutase (SOD) were measured. The determinants of serum UA levels and correlation between UA and cardiovascular disease were analyzed by regression. Results The prevalence of hyperuricemia was 21.9% (25.9% in men and 18.7% in women). Partial correlation analysis showed the level of serum UA was positively correlated with Hcy (r=0.163, P=0.000), body mass index(r=0.128, P=0.004) and triglyceride(r=0.133, P=0.003), and negatively correlated with HDL-C (r=-0.103, P=0.021). After adjustment for potential confounding factors, multivariate analysis showed eGFR (β=-2.044, t=-10.544, P=0.000), gender (β=42.065, t=4.700, P=0.000), Hcy (β=1.367, t=3.714, P=0.000), BMI (β=3.370, t=2.706, P=0.007), TG (β=14.120, t=2.589, P=0.010) and SOD (β=-0.636, t=-3.079, P=0.002) were independent determinants for UA levels in elderly patients. Logistic regression analysis indicated that mild elevation of UA levels was a risk factor of hypertension (OR=1.925, 95% CI=1.124-3.295) in women and OR=1.780(95% CI=1.010-3.136) in men]. High UA levels increased the risk of coronary heart disease in women [OR=1.710 (95% CI=1.157-2.526)], but decreased the risk of ischemic stroke in men [OR=0.524(95% CI=0.335-0.820)]. Conclusions In elderly patients, serum UA levels were affected by renal function, gender, BMI and serum Hcy, TG and SOD. Mildly elevated UA levels increased the risk of hypertension. High UA levels increased the risk of coronary heart disease in women and decreased the risk of ischemic stroke in men. Key words: Elderly patients; Uric acid; Hypertension; Coronary heart disease; Ischemic stroke

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老年患者血清尿酸水平与心血管疾病风险的决定因素

目的探讨老年患者血清尿酸水平的决定因素及其与心血管疾病的关系。方法采用横断面设计。共有1066名老年患者被连续纳入研究。进行人体测量和生活方式调查，并测量血清UA、脂质概况、葡萄糖、同型半胱氨酸（Hcy）和超氧化物歧化酶（SOD）。通过回归分析血清UA水平的决定因素以及UA与心血管疾病的相关性。结果高尿酸血症的患病率为21.9%（男性为25.9%，女性为18.7%）。偏相关分析显示，血清UA水平与Hcy（r=0.163，P=0.000）、体重指数（r=0.128，P=0.004）和甘油三酯（r=0.133，P=0.003）呈正相关，与HDL-C（r=-0.103，P=0.021）呈负相关。在校正了潜在的混杂因素后，多变量分析显示eGFR（β=-2.044，t=-10.544，P=0.000，Hcy（β=1.367，t=3.714，P=0.000）、BMI（β=3.370，t=2.706，P=0.007）、TG（β=114.120，t=2.589，P=0.010）和SOD（β=0.636，t=-3.079，P=0.002）是老年患者UA水平的独立决定因素。Logistic回归分析表明，UA水平的轻度升高是女性高血压的危险因素（OR=1.925，95%CI=1.24-3.295），男性为OR=1.780（95%CI=1.100-.136）]。高UA水平增加了女性患冠心病的风险[OR=1.710（95%CI=1.157-2.526）]，但降低了男性缺血性中风的风险[OR=0.524（95%CI=0.335-0.820）]。结论老年患者血清UA水平受肾功能、性别、BMI以及血清Hcy、TG和SOD的影响。UA水平轻度升高会增加患高血压的风险。高UA水平增加了女性患冠心病的风险，降低了男性患缺血性中风的风险。关键词：老年患者；尿酸；高血压；冠心病；缺血性中风

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