학술논문
Hyperuricemia is significantly associated with increased vascular stiffness in asymptomatic healthy Korean women / 무증상의 한국 여성에서 고요산혈증이 혈관 경직도에 미치는 영향
Document Type
Dissertation/ Thesis
Author
Source
Subject
Language
English
Abstract
최근 건강검진 목적으로 일반 혈액생화학 검사뿐 아니라 비 침습적인 방법인 상완 발목 맥파 속도를 이용한 혈관 경직도, 관상동맥 혈관촬영 CT를 이용한 관상 동맥 석회화가 포함되기도 한다. 혈청 요산과 심혈관계질환에 대해서는 많은 논문에서 그 연관성에 대해 입증하고 있으며 최근 일부 연구에는 무증상의 환자에서도 그 연관성에 대하여 보고하고 있다. 본 논문은 무증상의 건강검진을 받은 성인을 대상으로 혈청 요산 수치와 혈관 경직도의 관련성에 대해 연구하고자 하였다. 발목 맥박 파 전파속도에 영향을 줄 수 있는 다양한 임상변수들과 관상동맥 석회화 수치가 높을수록 발목 맥박 파 전파속도도 높은 점을 감안하여 이를 혼란 변수로 포함시켰다. 요산 수치는 남성과 여성에서 통계학적으로 차이가 보여 남성과 여성으로 분리하였으며 요산수치를 각각 4사분위로 구분하였다. 다양한 인자를 보정한 이후에도 이분형 회귀분석 및 선형 회귀 분석에서 혈청 요산 수치는 혈관 경직도와 의미 있는 상관관계를 가지고 있음을 확인하였다. 이러한 요산과 혈관 경직도의 관계는 여성에서 뚜렷하게 나타났지만 남성에서는 연관성이 없었다. 또한 한국 여성의 폐경기 나이 중앙값을 기준으로 하였을 때 폐경기 여성에서 요산 수치가 혈관 경직도에 통계학적으로 영향을 주는 것으로 나타났다. 본 연구는 무증상의 여성 건강 검진 환자에서 혈청 요산이 혈관 경직도와 연관성이 있다는 것을 보고 하였다.
Purpose: Increased serum uric acid is a known risk factor for cardiovascular disease. Brachial-ankle pulse wave velocity (baPWV) is a simple index of arterial stiffness, while the coronary artery calcium score (CACS) derived from multidetector computed tomography is a good marker of coronary atherosclerosis. Patients with coronary artery stenosis have significantly elevated baPWV values. Therefore, we investigated the relationship between serum uric acid level and baPWV in asymptomatic subjects, taking into account confounding factors, including CACS.Materials and Methods: Of 4894 patients who underwent baPWV measurement and coronary computed tomography angiography as part of a general health examination at Gangnam Severance Hospital from July 2006 through September 2013, 2720 healthy subjects were enrolled in this evaluation after exclusion of confounding factors. Serum uric acid level was divided into quartiles for men and women separately: men, Q1: 1.9-5.2, Q2: 5.21-5.9, Q3: 5.91-6.7, Q4: 6.71-12.1 mg/dL; women, Q1: 2.0-3.8, Q2: 3.81-4.3, Q3: 4.31-4.9, Q4: 4.91-8.7 mg/dL. High baPWV was defined as ≥1400 cm/s. Results: The mean concentration of serum uric acid was found to be significantly lower in women than in men (4.37±0.91 vs. 5.94±1.15 mg/dL, p50 years), the highest quartile of serum uric acid was associated with high baPWV, after adjustments for other risk factors (OR compared with lowest quartile=1.806, 95% CI=1.065-3.063; p=0.028).Conclusion: Serum uric acid is associated with aggravation of arterial stiffness in healthy Korean women, but not in men.
Purpose: Increased serum uric acid is a known risk factor for cardiovascular disease. Brachial-ankle pulse wave velocity (baPWV) is a simple index of arterial stiffness, while the coronary artery calcium score (CACS) derived from multidetector computed tomography is a good marker of coronary atherosclerosis. Patients with coronary artery stenosis have significantly elevated baPWV values. Therefore, we investigated the relationship between serum uric acid level and baPWV in asymptomatic subjects, taking into account confounding factors, including CACS.Materials and Methods: Of 4894 patients who underwent baPWV measurement and coronary computed tomography angiography as part of a general health examination at Gangnam Severance Hospital from July 2006 through September 2013, 2720 healthy subjects were enrolled in this evaluation after exclusion of confounding factors. Serum uric acid level was divided into quartiles for men and women separately: men, Q1: 1.9-5.2, Q2: 5.21-5.9, Q3: 5.91-6.7, Q4: 6.71-12.1 mg/dL; women, Q1: 2.0-3.8, Q2: 3.81-4.3, Q3: 4.31-4.9, Q4: 4.91-8.7 mg/dL. High baPWV was defined as ≥1400 cm/s. Results: The mean concentration of serum uric acid was found to be significantly lower in women than in men (4.37±0.91 vs. 5.94±1.15 mg/dL, p50 years), the highest quartile of serum uric acid was associated with high baPWV, after adjustments for other risk factors (OR compared with lowest quartile=1.806, 95% CI=1.065-3.063; p=0.028).Conclusion: Serum uric acid is associated with aggravation of arterial stiffness in healthy Korean women, but not in men.