高尿酸血症与心血管疾病(CVD)密切相关。然而,这种关联是否独立于传统心血管危险因素(CVRF)以及是否存在性别依赖性,目前尚未明确.这项研究的目的是调查基于人群的队列(年龄范围,50-64岁)按性别分层血清尿酸盐(SU)浓度与亚临床动脉粥样硬化之间的关系,正如冠状动脉钙化(CAC)评分所反映的那样,颈总动脉内中膜厚度(CIMT),颈动脉斑块评分。
该研究涉及瑞典心脏肺生物图像研究(SCAPIS)试点队列的参与者(N=1040;48.8%的男性)。这个试点队列是以人口为基础的大型SCAPIS的一部分,有30,000名参与者,年龄在50-64岁之间,旨在改善心血管疾病的风险预测。排除自我报告既往有CVD(N=68)或痛风(N=3)病史的受试者。CAC评分是通过使用计算机断层扫描的Agatston方法评估的。超声定量CIMT和颈动脉斑块。SU四分位数与CAC不同级别之间的关联,CIMT,颈动脉斑块采用多变量logistic回归分析。
年龄,BMI,教育水平,吸烟,身体活动,hs-CRP,高血压,血脂异常在男性和女性之间没有差异,而CAC(评分>0)和糖尿病在男性中的发病率都是女性的两倍(58%vs26%和8%vs4%,分别)。较高的SU四分位数在与BMI相关的两种性别中,hs-CRP,和高血压的患病率,而在女性中,它们还与血脂异常的患病率相关.SU的三个上四分位数(>308μmol/L)与男性较高的CAC得分有关,当调整CVRF时,但不是女人。在两种性别中,CIMT和颈动脉斑块与SU均无相关性。
较高的SU水平与男性中CAC的存在有关,但与女性无关。而SU在男性或女性中与CIMT或颈动脉斑块无关。这意味着SU的生物学作用在男性和女性中不同,或者SU对不同的血管床或在动脉粥样硬化过程的不同阶段具有不同的作用。
Hyperuricemia is closely associated with cardiovascular disease (CVD). However, it has not been definitively established whether this association is independent of traditional cardiovascular risk factors (CVRFs) and whether it is gender-dependent. The aim of this study was to investigate in a population-based cohort (age range, 50-64 years) stratified by sex the association between the serum urate (SU) concentration and subclinical atherosclerosis, as reflected in the coronary artery calcification (CAC) score, common carotid intima-media thickness (CIMT), and carotid plaque score.
The study involved participants in the Swedish CArdioPulmonary bioImage Study (
SCAPIS) Pilot cohort (N = 1040; 48.8% males). This pilot cohort is part of the large population-based
SCAPIS with 30,000 participants in the age range of 50-64 years, aimed at improving risk prediction for CVD. Subjects with a self-reported previous history of CVD (N = 68) or gout (N = 3) were excluded. The CAC score was assessed with the Agatston method using computed tomography. CIMT and carotid plaques were quantified by ultrasound. The associations between the SU quartiles and different levels of CAC, CIMT, and carotid plaques were assessed by multivariable logistic regression.
Age, BMI, education level, smoking, physical activity, hs-CRP, hypertension, and dyslipidemia showed no differences between males and females, while CAC (score > 0) and diabetes were both twice as common in men than in women (58% vs 26% and 8% vs 4%, respectively). Higher SU quartiles were in both sexes associated with BMI, hs-CRP, and the prevalence of hypertension, and in women, they were also associated with the prevalence of dyslipidemia. The three upper quartiles of SU (>308μmol/L) were linked to higher CAC scores in men, when adjusting for CVRFs, but not in women. CIMT and carotid plaques showed no correlation to SU in either sex.
Higher levels of SU are associated with the presence of CAC in men but not in women, whereas SU is not associated with CIMT or carotid plaques in either men or women. This implies that the biological effects of SU differ in men and women or that SU has varying effects on different vascular beds or during the different stages of the atherosclerotic process.