Uric acid (UA) is the final product of human purine metabolism. As one of the main antioxidants in the body, it can scavenge oxidative radicals. Under the action of oxidative-antioxidant shuttle mechanism, the antioxidant activity of UA can be reversed, causing inflammation and oxidative stress of vascular endothelial cells. Hyperuricemia (HUA) is considered to be one of the major risk factors for diabetes and diabetic nephropathy. The study of HUA in diabetic retinopathy (DR) is also a hot topic. UA can cause retinal vascular sclerosis, and affect the occurrence and development of DR by promoting oxidative stress and inducing neovascularization.
Objective To observe serum uric acid (UA) level of patients with optic neuritis (ON). Methods Thirty-nine patients with ON (ON group), 53 healthy control subjects (control group), 69 patients with multiple sclerosis (MS group) and 51 patients with neuromyelitis optica (NMO group) matched in age and sex were enrolled in the study. In ON group, there were 25 patients with papillitis and 14 patients with retrobulbar type ON. Twenty-eight patients were first time onset while 11 patients were recurrent. The disease duration was less than a year for 28 patients, and over a year for the remainder. Venous blood samples were collected from all individuals in the morning after an overnight fast. UA concentration was measured by the urate oxidaseindirect peroxidase couple assay. Differences of UA concentration were comparatively analyzed among all the groups. UA levels between different genders, different groups, different lesion sites, recurrence and duration of ON were comparatively analyzed. Results Serum UA level in ON group was significantly lower than that in control group (t=3.16,P＜0.05). However, no significant differences were found between ON and MS, ON and NMO, MS and NMO group (t=0.26, 0.94, 1.36;P＞0.05). Serum UA level was significantly lower in female than in male in all groups (F=6.27, 16.20, 21.09, 11.96;P＜0.05). In male and female patients of ON group, UA levels were significantly lower when compared with same gender in control group(t=2.13, 3.04;P＜0.05). However, no differences (P＞0.05) were found between ON and MS of same gender (t=0.25, 0.59), ON and NMO of same gender (t=0.33, 0.63), MS and NMO of same gender (t=0.63, 1.41). Patients with recurrent ON had lower serum UA level than that with first episodes (F=2.73). Patients with duration of over a year had lower serum UA level than that with duration of less than a year (F=0.23). Patients with retrobulbar neuritis also had lower serum UA level than that with papillitis (F=0.76). But the differences were not significant (P＞0.05). Conclusions A reduced serum UA level is found in patients with ON compared with healthy control. But serum UA level is not correlated with recurrence, lesion site or duration of disease.
Diabetic retinopathy is a vascular complication of diabetes, and homocysteine is an intermediate product of methionine metabolism. Hyperhomocysteinemia can directly or indirectly damage vascular endothelial cells, causing vascular endothelial cells dysfunction and participating in the occurrence and development of diabetic retinopathy. Uric acid is the final product of purine metabolism. Hyperuricemia can cause vascular endothelial dysfunction, oxidative metabolism, platelet adhesion and aggregation dysfunction, thus participating in the occurrence and development of diabetic retinopathy. In recent years, there have been many studies on the correlation between diabetic retinopathy and levels of homocysteine and uric acid. This article reviews the relevant literature at home and abroad in order to provide new information for the prevention and treatment of diabetic retinopathy.
目的 探讨中老年人群血清尿酸水平与代谢综合征（MS）及其各组分的关系。 方法 采用横断面研究，对2007年49～80岁成都成华区711例人群进行调查，并测量身高、体重、血压、空腹血糖、三酰甘油、高密度脂蛋白、低密度脂蛋白、血清尿酸等指标，采用SPSS 16.0软件分析尿酸与MS及MS各组分之间的关系。 结果 在中老年人群中，MS的发生率为25.60%，高尿酸血症的发生率为21.24%。女性MS、腹型肥胖、高三酰甘油血症和低高密度脂蛋白胆固醇血症的发生率均明显高于男性。尿酸与腰围、收缩压、三酰甘油、舒张压、高密度脂蛋白水平的相关系数分别为0.311、0.140、0.118、0.106和?0.147，均有统计学意义（P＜0.05）。男、女性尿酸与腰围的相关系数分别为0.173和?0.321，均有统计学意义（P＜0.05）。男、女性尿酸与空腹血糖的相关系数分别为?0.049和0.183，均有统计学意义（P＜0.05）。 结论 血清尿酸水平与MS及其各组分关系密切，血清尿酸水平和MS及其各组分间的关系存在性别差异。
【摘要】 目的 探讨无症状人群高尿酸血症与高甘油三酯血症的相关性，为临床疾病的预防和治疗提供实验基础研究。 方法 回顾分析2008年5月-2009年5月门诊体检中200名无临床症状高血尿酸者（A组）的血脂检查情况，并与同期200例血尿酸正常者（B组）的血脂检查情况进行比较分析。A组：男121例，女79例；年龄20～60岁，平均43岁。男性患者血尿酸gt;420 mmol/L，女性患者gt;360 mmol/L。 B组：男115例，女85例；年龄20～60岁，平均41岁。男性患者血尿酸为99～420 mmol /L，女性患者为99～360 mmol/L。两组性别和年龄差异无统计学意义（Pgt;0.05）。 结果 A组甘油三酯、总胆固醇、低密度脂蛋白、高密度脂蛋白分别为（3.09±0.98）、（4.05±1.07）、（3.38±0.98）、（1.30±0.51）mmol /L；B组为（1.65±0.86）、（3.99±0.99）、（2.97±0.89）、（1.41±0.66）mmol /L。 A组甘油三酯较B组比较，差异有统计学意义（Plt;0.01）；总胆固醇、低密度脂蛋白、高密度脂蛋白比较，差异无统计学意义（Pgt;0.05）。经相关性分析，A组血尿酸与甘油三酯呈正相关（r=0.69， Plt;0.01）。 结论 血尿酸代谢与甘油三酯代谢之间有一定的联系。【Abstract】 Objective To explore the correlation between hyperuricemia and hypertriglyceridemia in asymptomatic people to provide the basic information for clinical prevention and treatment. Methods The blood lipid (TG, TC, LDL, and HDL) levels in 200 asymptomatic individuals with high uric acid (A group) and 200 sex-and age-matched ones with normal serum uric acid (B group) were examined and the results of the two groups were compared. Results The concentration of triacylglycerol, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were (3.09±0.98), (4.05±1.07), (3.38±0.98), and (1.30±0.51) mmol/L, respectively in group A; and were (1.65±0.86), (3.99±0.99), (2.97±0.89), and (1.41±0.66) mmol /L, respectively in group B. The concentration of TG in group A was obvious higher than that in group B (Plt;0.01). However, the differences of their total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were not significant (Pgt;0.05). The increase of TG was obvious compared with TC(Plt;0.01), LDL (Plt;0.01), and HDL (Plt;0.01) in group A; while the comparisons in group B were not significant (Pgt;0.05). Conclusion Uric acid metabolism correlates with triacylglycerol metabolism.
Objective To explore the relationship between uric acid (UA) level and cardiovascular disease in patients with OSAHS and its clinical significance. Methods The electronic medical record system of the First hospital of Lanzhou University was used to collect 475 subjects who completed polysomnography (PSG) during hospitalization from January 2019 to May 2020. According to the Guidelines for the Diagnosis and Treatment of Obstructive Sleep Apnea Hypopnea Syndrome (Basic Version), the patients were divided into four group: control group [apnea-hypopnea index (AHI) <5 times/h, n=96], mild group (5≤AHI≤15 times/h, n=130), moderate group (15<AHI≤30 times/h, n=112), and severe group (AHI>30 times/h, n=137). The age, gender, body mass index (BMI), smoking history, drinking history, hypertension, diabetes mellitus, cardiovascular disease and biochemical indexes [including triglyceride, total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, glucose, UA, blood urea nitrogen (BUN), serum creatinine, lactate dehydrogenase, homocysteine], PSG indexes were observed and compared among the four groups, and the differences were compared by appropriate statistical methods. Binary logistic regression model was used to evaluate the correlation between various risk factors and cardiovascular disease. Results There were statistically significant differences in age, gender, BMI, drinking history, hypertension and cardiovascular disease among the 4 groups (P<0.05). The levels of UA and BUN in mild, moderate and severe groups were higher than those in the control group, with statistical significance (P<0.05). With the increasing of OSAHS severity, the level of UA increased. There was statistical significance in the incidence of cardiovascular disease among the four groups (P<0.05), and the highest incidence of arrhythmia was found among the four groups. And the incidence of cardiovascular disease increases with the increasing of OSAHS severity. Binary Logistic regression analysis showed that the risk factors for cardiovascular disease in OSAHS patients were age, UA and BUN (P<0.05). Conclusions The occurrence of cardiovascular disease in OSAHS patients is positively correlated with the severity of OSAHS. The level of UA can be used as an independent risk factor for cardiovascular disease in OSAHS patients. Therefore, reducing the level of UA may have positive significance for the prevention and control of the prevalence and mortality of cardiovascular disease in OSAHS patients.
Objective To study the relationship between the levels of plasma fibrinogen, serum bilirubin, uric acid and mild stenosis of coronary artery. Methods Patients with suspected myocardial ischemia who underwent coronary angiography in our hospital were divided into the coronary artery mild stenosis group and the normal control group according to the result of coronary arteriongraphy between April 2007 to May 2009. Logistic regression was used to identify the risk factor of mild stenosis of coronary artery. Results Two-hundred and seventy-nine patients involving 191 patients with mild stenosis of coronary artery and 88 patients with normal coronary artery were included. The factors of gender, age, history of hypertension or diabetes mellitus, smoking history, systolic blood pressure, levels of plasma fibrinogen and serum creatinin were significantly different between the two groups. Multivariate logistic regression models found that the factors of age (OR=1.084, 95%CI 1.040 to 1.129, Plt;0.001), hypertension (OR=3.025, 95%CI 1.462 to 6.261, P=0.003), diabetes mellitus (OR=2.519, 95%CI 1.066 to 5.951, P=0.035), smoking history (OR=5.412, 95%CI 2.186 to 13.401, Plt;0.001), plasma fibrinogen (OR=1.748, 95%CI 1.059 to 2.885, P=0.029), serum bilirubin (OR=0.599, 95%CI 0.418 to 0.858, P=0.005), and high-density lipoprotein (HDL) cholesterol (OR=0.219, 95%CI 0.049 to 0.985, P=0.048) were independently associated with mild stenosis of coronary artery. By contrast, the level of serum uric acid was not associated with mild stenosis of coronary artery. Conclusion Except for traditional risk factors, levels of fibrinogen and bilirubin are independent risk factors of mild stenosis of coronary artery.
Objective To assess the efficacy and safety Losartan for essential hypertension associated withhyperuricemia. Methods Included randomized controlled trials of Losartan versus Valsartan. Electronic searchconducted in CENTRAL, the Cochrane Library (until 2008, Issue 4), PubMed, EMBASE, Chinese Biomedicine database,Chinese Scientific Journals Full-text Database, and China Journal Full-text Database (until 2008, Issue 10). Two reviewers extracted data independently. RevMan 5.0 software developed by the Cochrane Collaboration was used for Metaanalysis.Results Only 7 trials with 1 136 eligible patients were included in the systematic review. Meta-analysis showedno significant difference in reductions of systolic blood pressure, diastolic blood pressure, and adverse events betweenLosartan and Valsartan groups. However, a significant difference of serum uric acid reduction was observed betweenLosartan and Valsartan group. Losartan play a significant role of decreased serum uric acid levels. Conclusions Based on this systematic review, Losartan is effective and well tolerated in reducing BP and serum uric acid levels. Further large randomized, double blind, placebo controlled trials are needed in long-term safety and efficacy and different subgroups of Losartan.