CAJ | 학술논문

目的探讨血尿酸水平变化与冠状动脉病变程度、代谢综合征及其相关组分的关系.方法 343例(男性223例,女性120例)接受冠状动脉造影检查的患者,应用冠脉狭窄指数(CSI)评价冠状动脉病变严重程度.结果 (1)女性血尿酸水平显著低于男性[(306.3±76.9对358.9±85.2)μmol/L,P＜0.01],而男女性代谢综合征及各组分的患病率未见明显差异.(2)女性≥3项代谢异常亚组血清尿酸水平显著高于1项代谢异常亚组(P＜0.01)及2项代谢异常亚组(P＜0.05),而男性尿酸水平与代谢异常数目无明显关系.(3)将男、女人群的尿酸值分为4分位数,女性位于上1/4位点者的CSI评分高于下1/4位点者[7.0(2.5～12.0)对2.0(0.0～6.0),P=0.025].女性多支病变组血尿酸水平明显高于无病变组[(327.0±81.9对284.9±78.6)μmol/L,P=0.033].(4)Logistic回归显示年龄(β=0.042,P=0.007)和血脂异常(β=0.836,P=0.037)为男性冠脉病变的独立危险因素,而女性人群中血压异常(β=1.127,P=0.039)及血脂异常(β=0.901,P=0.009)为影响冠脉病变的主要因素.结论血尿酸水平较高的女性,代谢异常组分聚集较多,其冠状动脉病变程度较重,故尿酸水平可作为女性动脉粥样硬化的标志.
목적 탐토혈뇨산수평변화여관상동맥병변정도、대사종합정급기상관조분적관계.방법 343례(남성223례,녀성120례)접수관상동맥조영검사적환자,응용관맥협착지수(CSI)평개관상동맥병변엄중정도.결과 (1)녀성혈뇨산수평현저저우남성[(306.3±76.9대358.9±85.2)μmol/L,P＜0.01],이남녀성대사종합정급각조분적환병솔미견명현차이.(2)녀성≥3항대사이상아조혈청뇨산수평현저고우1항대사이상아조(P＜0.01)급2항대사이상아조(P＜0.05),이남성뇨산수평여대사이상수목무명현관계.(3)장남、녀인군적뇨산치분위4분위수,녀성위우상1/4위점자적CSI평분고우하1/4위점자[7.0(2.5～12.0)대2.0(0.0～6.0),P=0.025].녀성다지병변조혈뇨산수평명현고우무병변조[(327.0±81.9대284.9±78.6)μmol/L,P=0.033].(4)Logistic회귀현시년령(β=0.042,P=0.007)화혈지이상(β=0.836,P=0.037)위남성관맥병변적독립위험인소,이녀성인군중혈압이상(β=1.127,P=0.039)급혈지이상(β=0.901,P=0.009)위영향관맥병변적주요인소.결론 혈뇨산수평교고적녀성,대사이상조분취집교다,기관상동맥병변정도교중,고뇨산수평가작위녀성동맥죽양경화적표지.
Objective To analyze the association of blood uric acid level with the severity of coronary artery stenotic changes, metabolic syndrome (MS), and its components. Methods A total of 343 individuals ( male 223,female 120) who underwent coronary angiography and had complete data on MS and serum uric acid were collected. The severity of coronary artery disease (CAD) was assessed by the coronary stenesis index (CSI). MS was diagnosed according to the Guideline on Prevention and Treatment of Blood Lipid Abnormality in Chinese Adults. Results (1)The mean uric acid level was significantly lower in women than in men [ ( 306.3±76.9 vs 358.9±85.2 ) μmol/L, P＜0.01 ]. The prevalence of MS and its components showed no difference between men and women. (2) The uric acid level in women with 3 components was higher than those with1( P＜0. 01 ) or 2 ( P＜0.05 ) components of metabolic disorders, but not in men. (3) Quartiles of concentration of uric acid were computed. Compared with those in the lowest quartile of uric acid, women in the highest quartile had higher CSI score [ 7.0 (2.5-12.0) vs 2. 0( 0.0-6.0), P= 0. 025 ]. Moreover, the uric acid level was higher in women with multivessel lesions than nonCAD patients [ (327.0±81.9 vs 284.9±78.6) μmol/L, P = 0.033 ]. However, no correlation was found between uric acid level and the severity of coronary artery lesion in men. (4) Logistic regression showed that age (β=0.042, P=0. 007) and dyslipidemia(β=0.836, P=0. 037 ) were the independent risk factors of CAD in men, and hypertension(β=1. 127, P=0.039) and dyslipidemia(β=0.901, P=0.009)in women. Conclusions In women with higher uric acid level, the clustering of metabolic abnormalities was increased, and the coronary artery lesion was more severe. High uric acid level might be a marker of CAD for women.