尿酸與心血管疾病危險因子相關性之性別差異

Sex Differences in the Relationships between Risk Factors for Serum Uric Acid and Cardiovascular Disease

陳威志(Wei-Chih Chen) ； 陳鏡任(Jenn-Ren Chen) ； 楊士恒(Shih-Heng Yang)

《北市醫學雜誌》 7卷1期 (2010/03) Pp. 21-33

https://doi.org/10.6200/TCMJ.2010.7.1.03

摘要

目的：探討男性與女性尿酸值與心血管危險因子的關係。方法：本研究回溯性地分析一群年齡超過40歲且在2006年4至8月於台北市某區域醫院接受健檢的民眾，以其完整的病史、理學檢查及實驗室檢查所得的資料進行尿酸及心血管危險因子的分析。結果：有效樣本共有585人，其平均年齡為56.9±9.8歲，其中女性有388人(66.3%)；男性有197人(33.7%)。高尿酸血症的總盛行率為14.9%，不論男女，高尿酸血症的受檢者有較高的身體質量指數(BMI)及較低的腎絲球過濾率(eGFR)。女性受檢者中，患高尿酸血症者，年齡相對較大，膽固醇也相對較高。在尿酸與心血管相關因子的相關性分析中，以男性的統計資料觀察，尿酸與BMI呈正相關而與GFR呈負相關；而在女性中也有類似現象，女性受檢者的尿酸值與年齡、BMI，血壓（舒張壓和收縮壓）以及膽固醇呈正相關，與GFR也呈負相關。將年齡、BMI和GFR值控制後，可發現尿酸與男性高血壓（勝算比1.43, p=0.018）和女性高膽固醇有顯著相關性（勝算比1.37, p=0.006）。結論：尿酸和心血管危險因子的相關性存在性別差異。男性高尿酸血症和高血壓具顯著相關，女性高尿酸血症則是和高膽固醇具顯著相關性。

關鍵字

尿酸 ； 高尿酸血症 ； 心血管疾病 ； 身體質量指數 ； 健檢

並列摘要

Objectives: To investigate the sex differences in the relationship between uric acid (UA) level and cardiovascular risk factors. Methods: We retrospectively analyzed subjects aged over 40 year-old who had undergone a health check-up in Taipei City, Taiwan from April to August, 2006. A complete history was taken, a physical examination carried out and laboratory tests were performed for each subject by well-trained staff. Serial comparisons were carried out to evaluate the association between UA and various cardiovascular risk factors for both sexes. Results: A total of 585 subjects (mean age: 56.6±9.8 years, 66.3% female) were enrolled. The prevalence of hyperuricemia was 14.9% (16.8% among women and 11.2% among men). Both males and females with hyperuricemia had significantly higher body mass indices (BMIs) (24.5±2.9 kg/m^2 versus 23.2±3.3 kg/m^2, p=0.005 in women and 26.5±3.9 kg/m^2 versus 24.6±3.2, p=0.014 in men) and a lower glomerular filtration rate (GFR) (109.4±19.0 mL/min/1.73 m^2 versus 125.2±23.6 mL/min/1.73 m^2, p＜0.001 in women and 102.8±19.8 mL/min/1.73 m^2 versus 112.8±22.6 mL/min/1.73 m^2, p=0.049 in men). In addition, women with hyperuricemia were older (58.9±9.4 years versus 54.9±9.0, p=0.001) and had a higher level of cholesterol (224.5±32.8 mg/dL versus 208.9±35.1 mg/ dL p=0.001). Among men, UA showed a statistically significant positive correlation with BMI, but showed a statistically significant negative correlation with GFR. Among women, UA showed a statistically significant positive correlation with age, BMI, systolic and diastolic blood pressure and cholesterol, but showed a statistically significant negative with GFR. When age, BMI and GFR were controlled for, UA was significantly related to high blood pressure in men (odds ratio: 1.43, p=0.018) and hypercholesterolemia in women (odds ration: 1.37, p=0.006). Conclusion: A positive association was identified between serum UA and various cardiovascular risk factors, but these were different for men and women. Specifically, hyperuricemia is significantly related to high blood pressure in men and to hypercholesterolemia in women.

並列關鍵字

uric acid ； hyperuricemia ； cardiovascular disease ； body mass index ； health screening