不同血尿酸水平痛风病人发生冠状动脉钙化的危险性分析

王璐瑶; 施杰; 李然; 李雪玲; 王贵红; 王祥发

不同血尿酸水平痛风病人发生冠状动脉钙化的危险性分析

Risk analysis of coronary artery calcification in gout patients with different serum uric acid levels

摘要

摘要:
目的： 分析不同血尿酸水平痛风病人发生冠状动脉钙化（CAC）的危险性。
方法： 选取痛风病人378例，收集性别、年龄、高血压（HTN）、2型糖尿病（T2DM）、吸烟、估算肾小球滤过率（eGFR）、稳定期血尿酸、总胆固醇(Tch)、三酰甘油（TG）、高密度脂蛋白(HDL-C)、低密度脂蛋白（LDL-C）和冠状动脉钙化评分（CACS）。将血尿酸4分组（Q1：352 ~ 444 μmol/L、Q2：445 ~ 524 μmmol/L、Q3：525 ~ 604 μmol/L和Q4：605 ~ 817 μmol/L），CACS分为CACS = 0和CACS ＞ 0 2组。将血尿酸（不分组和4分组）与CACS作单因素二元Logistic回归；然后再将性别、年龄、HTN、T2DM、吸烟、eGFR）、血尿酸（4分组）、Tch、TG、HDL-C和LDL-C一起和CACS作多因素二元Logistic回归。
结果： 单因素二元logistic回归发现，痛风病人血尿酸升高（无论不分组还是分组），CAC风险增加（P ＜ 0.01）。校正了性别、年龄、HTN、T2DM、吸烟、eGFR、Tch、TG、HDL-C和LDL-C后的多因素二元Logistic回归分析显示，痛风病人血尿酸水平仍与CAC有关。血尿酸水平越高，CAC风险越大（Q2 vs Q1，OR = 1.143，P = 0.82；Q3 vs Q1，OR = 8.508，P ＜ 0.01；Q4 vs Q1，OR = 60.770，P ＜ 0.01）。
结论： 痛风病人血尿酸水平越高，罹患CAC的可能性越大。

Abstract:
Objective To analyze the risk of coronary artery calcification (CAC) in gout patients with different serum uric acid levels.
Methods The gender, age, hypertension (HTN), type 2 diabetes mellitus (T2DM), smoking, estimated glomerular filtration rate (eGFR), stable period serum uric acid, total cholesterol (Tch), triglycerides (TG), high-density lipoprotein (HDL-C), low-density lipoprotein (LDL-C) and CAC score in 378 gout patients were investigated. The serum uric acid was divided into four groups (352 ~ 444 μmol/L, 445 ~ 524μmmol/L, 525 ~ 604 μmol/L and 605 ~ 817 μmol/L), and the CAC was divided into two groups (CACS = 0 and CACS ＞ 0). The serum uric acid (ungrouped and 4-grouped) and CACS were used as univariate binary Logistic regression. Then the gender, age, HTN, T2DM, smoking, eGFR, blood uric acid (4 groups), Tch, TG, HDL-C and LDL-C were combined with CACS for multivariate binary Logistic regression.
Results The results of univariate binary Logistic regression showed that the risk of CAC increased with the serum uric acid levels of gout patients increasing (both ungrouped and grouped) (P ＜ 0.01). After adjusting the gender, age, HTN, T2DM, smoking, eGFR, Tch, TG, HDL-C and LDL-C, the results of multivariate binary Logistic regression still indicated an association between serum uric acid levels and CAC in gout patients. The higher the blood uric acid level, the greater the risk of CAC (Q2 vs. Q1, OR = 1.143, P = 0.82; Q3 vs. Q1, OR = 8.508, P ＜ 0.01; Q4 vs. Q1, OR = 60.770, P ＜ 0.01).
Conclusions The higher the blood uric acid level of a person with gout, the more likely they are to develop CAC.

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