【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 evaluate the correlation between hyperuricemia (HUA) and benign prostatic hyperplasia (BPH). Methods A total of 666 elderly male patients, who had been admitted to the West China Hospital for routine physical examination in May, 2010, were included in this study. All the following indexes were collected: blood pressure, waistline, medical history, international prostatic symptom score (IPSS), serum uric acid (UA), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), fasting blood glucose (FBG), 2-hour postprandial blood glucose (PBG-2), prostate-specific antigen (PSA), and prostate volume (PV) measured by ultrasound. Patients with higher level of UA more than 420 μmol/L were included into the HUA group (n=151) while the other patients with normal UA (NUA) were in the NUA group (n=515). Both the metabolic and prostate related indexes in the two groups were compared, and the correlation between HUA and each indexes were analyzed using logistic regression model. Results HUA was significantly associated with abdominal obesity (OR=1.575, 95%CI 1.059 to 2.340), hypertriglyceridemia (OR=2.78, 95%CI 1.877 to 4.118), metabolic syndrome (CDS2007) (OR=1.912, 95%CI 1.267 to 2.885), BPH (OR=1.464, 95%CI 1.465 to 1.635) and lower urinary tract symptoms (LUTS) rating (OR=1.782, 95%CI 1.173 to 1.522). Conclusion HUA is correlated with BPH, meanwhile it is highly accompanied with other risk factors of cardioascular diseases. Hereby, comprehensive medical screening should be considered when treating such patients.
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 compare the efficacy and safety of benzbromarone vs. allopurinol for primary gout. Methods Searching PubMed, Cochrane Library, EMbase, CNKI, VIP and CBM, randomized controlled trials were collected and the quality of RCTs was evaluated using Cochrane systematic review. Meta-analysis was performed. Results 6 RCTs were included in this study,with a total of 350 patients. Meta-analysis showed that there was no statistical significance in total effective rate between two groups (Pgt;0.05). 4 RCTs were enrolled in comparison of ADR. There was statistical significance between two groups (Plt;0.05). Conclusion There is no significant difference in the efficacy between benzbromarone and allopurinol for the primary gout.But benzbromarone is safe than allopurinol for primary gout .
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.
ObjectiveTo explore the optimal conditions of rat model of hyperuricemia (HUA) induced by different doses of potassium oxanate (PO) combined with adenine, and to provide reference for the treatment of HUA.MethodsMale Sprague-Dawley rats (220-240 g body weight) were divided into normal control group, potassium oxanate (1000, 1500 mg/kg) and adenine (0, 50, 100 mg/kg) combined model groups, with 8 rats in each group. After 5 weeks of intragastric administration, blood were collected from tail vein of rats every week, and serum uric acid, creatinine and blood urea nitrogen level were measured. At the 6th week, the changes of the pathological characteristics, expression of inflammatory and fibrosis-related factors in the kidneys were observed.ResultsIn the 1500 mg/kg potassium oxanate combined with 100 mg/kg adenine group, rats died after 2 weeks of molding, and the survival rate at the 6th week was 62.5%; but there was no significant difference between the other groups and the normal control group in survival rate (P>0.05). Compared with the normal group, the level of serum uric acid in each model group increased significantly after 1 week of molding (P<0.05), but recovered to the pre-model level after stopping intragastric administration in week 6. After 5 weeks, in model groups the levels of serum creatinine and blood urea nitrogen were higher than those in the normal control group; and the inflammation and fibrosis-related factors mRNA and protein expression of kidney tissue in model groups increased with the increase of ademine dose, and there was a significant difference in the PO 1 000 mg/kg with adenine 100 mg/kg group, PO 1 500 mg/kg with Adenine 50 mg/kg group compared to the normal control group (P<0.05). The results of renal anatomy and histology testing in rats showed that with the increased of the dosage of PO and adenine in the model groups, the increase of white deposition of renal medulla, tubulointerstitial fibrosis, and tubular epithelial cell necrosis was found, and the glomerular atrophy aggravated. Compared with the indexes in the normal control group, the expression levels of inflammation and fibrosis related genes and proteins in the 50 mg/kg adenine combined with 1 500 mg/kg PO group were higher, and inflammatory cell infiltration and fibrosis were observed, which was consistent with the clinical manifestation of hyperuricemia induced renal injury.ConclusionPO (1500 mg/kg) combined with adenine (50 mg/kg) can establish a stable hyperuricemic nephropathy model in rats.
Objective To study the risk factors of hyperuricemia in patients with mild coronary artery stenosis. Methods The clinical data of 267 patients, who underwent coronary angiography, were collected and classified into the hyperuricemia group (58.5±8.0 years) and the normal control group (57.3±9.9 years). The coronary artery diameter stenosis of all the patients was lower than 50%. Results Elevated levels of body mass index (BMI), serum creatinine, triglyceride, low level of high-density lipoprotein, and history of hypertension or diabetes mellitus were significantly correlated with increased prevalence of hyperuricemia in patients with mild coronary artery stenosis. Multivariate logistic regression models found that the risk factors were diabetes mellitus (OR=1.999, 95%CI 1.087 to 3.678) , BMI (OR=1.110, 95%CI 1.009 to 1.221), hypertriglyceridemia (OR=1.237, 95%CI 1.023 to 1.496), and serum creatinine (OR=1.026, 95%CI 1.008 to 1.045). Conclusion Diabetes mellitus, BMI, hypertriglyceridemia and serum creatinine are independent risk factors of hyperuricemia in patients with mild coronary artery stenosis.
Objective To investigate the prevalence of hyperuricemia and the current status as well as differences of cardiovascular risk factors in hyperuricemia patients between urban and rural areas in Chengdu. Methods We randomly sampled 2 032 patients aged from 35 to 70 years age in urban and rural communities, using a questionnaire, physical examination and laboratory tests. Results a) The prevalence of hyperuricemia was 17.77%, which was higher in urban residents (21.38%) than that in rural residents (14.16%). b) The prevalence of hyperuricemia associated with hypercholesterolemia was higher in urban residents (34.10%) than that in rural residents (13.98%); urban women (39.06%) were higher than rural women (16.13%) and urban men (26.97%) were higher than rural men (12.20%). c) The prevalence of hyperuricemia associated with hypertension which was higher in urban residents (58.06%) than that in rural residents (32.64%); urban women (59.38%) were higher than rural women (35.48%) and urban men (56.18%) were higher than rural men (30.49%). d) The prevalence of hyperuricemia associated with impaired glucose tolerance (IGT) in urban women (28.91%) were lower than that in rural women (45.16%). Conclusion Hypercholesterolemia and hypertension are the most commonly seen cardiovascular risk factors accompanied in patients with hyperuricemia in urban areas, which has obviously higher prevalence than in rural areas. IGT is the most commonly seen cardiovascular risk factors accompanied in patients with hyperuricemia among rural women. But in aspects of hyperuricemia associated with impaired fasting glucose (IFG), hypertriglyceridemia, low high-density fetoprotein cholesterol, abdominal obesity and obesity, there is no difference between urban and rural areas.