血尿酸水平与超极速脉搏波传导速度的相关性及其在性别间的差异  

Association of serum uric acid level with ultrafast pulse velocity and gender differences

作　　者：高慧[1] 朱正球[1] 刘福明[2] 邹冲[3] 戴萍 马学慧 黄辉[1] GAO Hui;ZHU Zhengqiu;LIU Fuming;ZOU Chong;DAI Ping;MA Xuehui;HUANG Hui(Department of Ultrasound,The Affiliated Hospital of Nanjing University of Chinese Medicine,Jiangsu Province Hospital of Chinese Medicine,Nanjing 210029,China;Department of Cardiology,The Affiliated Hospital of Nanjing University of Chinese Medicine,Jiangsu Province Hospital of Chinese Medicine,Nanjing 210029,China;Center of Good Clinical Practice,The Affiliated Hospital of Nanjing University of Chinese Medicine,Jiangsu Province Hospital of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]江苏省中医院·南京中医药大学附属医院超声医学科,江苏南京210029 [2]江苏省中医院·南京中医药大学附属医院心血管内科,江苏南京210029 [3]江苏省中医院·南京中医药大学附属医院GCP中心,江苏南京210029

出　　处：《西部医学》2022年第12期1807-1811,共5页Medical Journal of West China

基　　金：江苏省第十六批“六大人才高峰”创新人才团队项目(TD-SWYY-069)。

摘　　要：目的探讨血尿酸水平与超极速脉搏波传导速度(ufPWV)的相关性及其在性别间的差异。方法选取2016年3月~2020年12月在南京中医药大学附属医院体检人群130例,具有动脉粥样硬化危险因素患者226例,共356例,分别根据男女血尿酸水平的四分位数将全部人群分为Q1、Q2、Q3、Q4共4组。利用ufPWV技术检测颈动脉收缩起始脉搏波速度(PWV-BS)和收缩末期脉搏波速度(PWV-ES)。比较不同尿酸水平间及男性女性间PWV-BS、PWV-ES差异。分析血尿酸水平与年龄、BMI、eGFR等临床资料间的相关性。应用Logistic回归分析血尿酸水平与ufPWV增高的关系。结果随着血尿酸水平增高,年龄、BMI、TC、Scr、PWV-ES及高血压患病率显著增高,eGFR、HDL显著降低。男性血尿酸、PWV-BS及PWV-ES均显著高于女性(P分别为<0.001、0.0024、0.0018),男性血尿酸与PWV-BS、PWV-ES均不相关,女性血尿酸仅与PWV-ES呈正相关(r=0.265,P<0.05)。男性与女性血尿酸均与BMI、TC、Scr成显著正相关,与HDL、eGFR成显著负相关,并且女性相关程度大于男性。Logistic回归显示以Q1组为对照,在矫正了年龄、BMI、SBP、DBP、TC、TG、HDL、LDL、FBG、Scr、吸烟、高血压、糖尿病等混杂因素后,血尿酸Q4组可独立于上述因素成功预测PWV-ES增高的风险,女性(OR:5.15,95%CI:1.20~22.10,P=0.027),全体人群(OR:2.41,95%CI:1.42~5.69,P=0.042),但该因子预测价值不能独立于eGFR而存在。结论血尿酸可间接反应动脉硬化的进展,同时PWV-ES可作为血尿酸对血管功能损伤早期无创性评估的指标;血尿酸是女性动脉粥样硬化的独立危险因素,但其预测价值具有一定的eGFR依赖性。Objective To explore the relationship between serum uric acid and ultrafast pulse velocity(ufPWV)and its gender difference.Methods A total of 356 cases were enrolled,including 130 check-up population and 226 patients with atherosclerosis risk factors.According to the quartile of serum uric acid level of male and female respectively,the whole population was divided into Q1,Q2,Q3,and Q4 groups.The initial-systolic pulse wave velocity(PWV-BS)and end-systolic pulse wave velocity(PWV-ES)of bilateral carotid artery were measured by ufPWV.The differences of PWV-BS and PWV-ES among different serum uric acid levels and between male and female were compared.The correlation between serum uric acid and clinical data was analyzed.Logistics regression was used to analyze the relationship between serum uric acid level and high ufPWV.Results Those in the higher quartiles of serum uric acid tend to be older,had higher BMI,TC,Scr,PWV-ES and lower eGFR,HDL,had a high prevalence of hypertension.Serum uric acid,PWV-BS and PWV-ES in males were significantly higher than those in females(P<0.001,0.0024,0.0018,respectively),but there was no correlation between serum uric acid and PWV-BS and PWV-ES in males,while there was a positive correlation between serum uric acid and PWV-ES in females(r=0.265,P=0.000).Serum uric acid was significantly positively correlated with BMI,TC and Scr,and negatively correlated with HDL and eGFR in both males and females,and the degree of correlation was greater in females than in males.Logistic regression shows Q1 as reference,after adjusted confounding factors such as age,BMI,SBP,DBP,TC,TG,HDL,LDL,FBG,Scr,smoking,high blood pressure,diabetes,Q4 can independently predict the risk of high PWV-ES of women(OR:5.15,95%CI:1.20-22.10,P=0.027),and all the people(OR:2.41,95%CI:1.42-5.69,P=0.042),but the predictive value could not be independent of eGFR.Conclusion There is a certain correlation between serum uric acid and PWV-ES,and there is a significant gender difference.Serum uric acid is an independent risk facto

关 键 词：超极速脉搏波 血尿酸 动脉粥样硬化 颈动脉 性别 

分 类 号：R589[医药卫生—内分泌]