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研究生:施曉雅
研究生(外文):Hiu-Ngar Sy
論文名稱:正常人的尿酸與頸動脈硬化的關係
論文名稱(外文):Relation between serum uric acid and carotid atherosclerosis in healthy persons
指導教授:譚秀芬譚秀芬引用關係
指導教授(外文):Hsiu-Fan Tam
學位類別:碩士
校院名稱:長榮大學
系所名稱:醫學研究所
學門:醫藥衛生學門
學類:醫學學類
論文種類:學術論文
論文出版年:2008
畢業學年度:97
語文別:英文
論文頁數:54
中文關鍵詞:血清尿內膜中層厚度斑塊指數頸動脈
外文關鍵詞:Serum uric acidIntima-medium thicknessPlaque scoreCarotid artery
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目的:
探討在校正各種與頸動脈硬化相關的危險因子以後,正常人的血清尿酸值是否與頸動脈硬化有直接的關係
方法:
收集從2006年5月至2006年12月間, 從彰化基督教醫院健康檢查中心篩選出有接受高階健康檢查的健康人士; 其中一定包含頸動脈超音波與各種生物化學的檢查。 所收集的數據包括頸動脈超音波中的斑塊分數與內膜中層厚度,血清中的尿酸,血糖,三酸甘油脂,高密度膽固醇, 低密度膽固醇, 總膽固醇。統計上, 首先取得尿酸是否與各種心血管疾病的危險因之有相關。 再分析造成頸動脈硬化的相關因之, 最後執行羅吉斯回歸分析去評估尿酸是否造成頸動脈硬化的獨立因子。
結果:
去除有心血管疾病病史的個案, 半年內計有一仟人次(395位女性,605位男性)接受本院的高階檢查。有頸動脈硬化的女性與正常女性相比,血清中尿酸明顯偏高 (5.5 vs.4.8mg/dl, p<0.001); 但男性側沒有此一差異(6.5 vs.6.5mg/dl, p> 0.05)。 女性的血清尿酸跟年齡有明顯相關(r=0.320, p<0.001); 男性不會有此相關(r=-0.052,
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p> 0.05)。 因尿酸平均值在兩性間存有差異, 故以各組尿酸值作四分位法去執行羅吉斯回歸分析。在把其他相關危險因子校正後, 各組尿酸四分位法與頸動脈硬化的勝算比比值沒有增加。
結論:
根據上述結果可以得知, 在台灣的健康男性或女性, 尿酸跟其他動脈硬化的危險因子一樣與頸動脈硬化有關聯。 但高血清尿酸卻不是一個動脈硬化的獨立危險因子。
OBJECTIVE:
The purpose of this study is to assess whether there was an independent association of SUA to carotid atheroclerosis in healthy individuals after adjusting for other confounding risk factors for atherosclerosis
Methods:
We retrospectively reviewed the medical records of who received health screen including carotid ultrasound. Participants with a history of CVD were excluded from the study. The biochemical data and report of carotid ultrasonography were collected from medical records. SUA level was compared among women/men with or without carotid atherosclerosis. Atherosclerosis prevalence as well as other risk factors was also compared among sex-specific quartile SUA groups using chi-square (for categorical variable) and ANOVA (for continuous variable). Finally, multivariate logistic regression model was used to investigate if quartile SUA is an independent risk factor for atherosclerosis after adjusting for
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age, glucose, LDL, HDL and TG.
Result:
A total of 1,000 participants (395 female aged 18-78 years and 605 male aged 21-80 years) were recruited in this study. SUA was significantly higher in women with atherosclerosis than without (5.5 vs. 4.8 mg/dl, p<0.001) but not in men (6.5 vs. 6.5 mg/dl, p> 0.05). There was a significantly positive correlation between SUA and age in women (r=0.320, p<0.001), but not in men (r=-0.052, p> 0.05). Multivariate logistic regression showed no increased odds ratios across the sex-specific quartile SUA, after adjusting for other risk factors.
Conclusion:
These results suggested that, in both genders, there is an association between SUA and other risk factors for atherosclerosis, but hyperuricemia might not be an independent risk factor for atherosclerosis in healthy Taiwanese adults..
中文摘要 (Chinese abstract)
2
英文摘要 (abstract)
4
重要英文名詞縮寫對照
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第一章 introduction
7
第二章 Methods
15
第三章 Results
22
第四章 Discussion
42
第五章 conclusion
47
Reference
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附錄 54
1. Ross, R., The pathogenesis of atherosclerosis: a perspective for the 1990s. Nature, 1993. 362(6423): p. 801-9.
2. Lahoz, C. and J.M. Mostaza, [Atherosclerosis as a systemic disease]. Rev Esp Cardiol, 2007. 60(2): p. 184-95.
3. Mathias, T.A., M.H. Jorge, and R. Laurenti, Cardiovascular diseases in the elderly: analysis of the behavior of mortality in a municipality in the Southern Region of Brazil from 1979 to 1998. Arq Bras Cardiol, 2004. 82(6): p. 533-50.
4. Pignoli, P., et al., Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging. Circulation, 1986. 74(6): p. 1399-406.
5. Howard, G., et al., Carotid artery intimal-medial thickness distribution in general populations as evaluated by B-mode ultrasound. ARIC Investigators. Stroke, 1993. 24(9): p. 1297-304.
6. Sidhu, P.S. and S.R. Desai, A simple and reproducible method for assessing intimal-medial thickness of the common carotid artery. Br J Radiol, 1997. 70: p. 85-9.
7. Salonen, J.T. and R. Salonen, Ultrasound B-mode imaging in observational studies of atherosclerotic progression. Circulation, 1993. 87(3 Suppl): p. II56-65.
8. Visona, A., et al., Intimal medial thickening of common carotid artery as indicator of coronary artery disease. Angiology, 1996. 47(1): p. 61-6.
9. Nichols, W.W., C.J. Pepine, and M.F. O''Rourke, Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke. N Engl J Med, 1999. 340(22): p. 1762-3.
10. O''Leary, D.H., et al., Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group. N Engl J Med, 1999. 340(1): p. 14-22.
11. Zureik, M., et al., Common carotid intima-media thickness predicts occurrence of carotid atherosclerotic plaques: longitudinal results from the Aging Vascular Study (EVA) study. Arterioscler Thromb Vasc Biol, 2000. 20(6): p. 1622-9.
- 49 -
12. Ebrahim, S., et al., Carotid plaque, intima media thickness, cardiovascular risk factors, and prevalent cardiovascular disease in men and women: the British Regional Heart Study. Stroke, 1999. 30(4): p. 841-50.
13. Lernfelt, B., et al., Cerebral atherosclerosis as predictor of stroke and mortality in representative elderly population. Stroke, 2002. 33(1): p. 224-9.
14. Glantzounis, G.K., et al., Uric acid and oxidative stress. Curr Pharm Des, 2005. 11(32): p. 4145-51.
15. Nieto, F.J., et al., Uric acid and serum antioxidant capacity: a reaction to atherosclerosis? Atherosclerosis, 2000. 148(1): p. 131-9.
16. Waring, W.S., D.J. Webb, and S.R. Maxwell, Systemic uric acid administration increases serum antioxidant capacity in healthy volunteers. J Cardiovasc Pharmacol, 2001. 38(3): p. 365-71.
17. Hsu, C.C., M.C. Yin, and R. Tian, Ascorbic acid and uric acid suppress glucose-induced fibronectin and vascular endothelial growth factor production in human endothelial cells. J Diabetes Complications, 2005. 19(2): p. 96-100.
18. Scott, G.S. and D.C. Hooper, The role of uric acid in protection against peroxynitrite-mediated pathology. Med Hypotheses, 2001. 56(1): p. 95-100.
19. Hayden, M.R. and S.C. Tyagi, Uric acid: A new look at an old risk marker for cardiovascular disease, metabolic syndrome, and type 2 diabetes mellitus: The urate redox shuttle. Nutr Metab (Lond), 2004. 1(1): p. 10.
20. Kanellis, J. and D.H. Kang, Uric acid as a mediator of endothelial dysfunction, inflammation, and vascular disease. Semin Nephrol, 2005. 25(1): p. 39-42.
21. Puig, J.G. and L.M. Ruilope, Uric acid as a cardiovascular risk factor in arterial hypertension. J Hypertens, 1999. 17(7): p. 869-72.
22. Patterson, R.A., E.T. Horsley, and D.S. Leake, Prooxidant and antioxidant properties of human serum ultrafiltrates toward LDL: important role of uric acid. J Lipid Res, 2003. 44(3): p. 512-21.
23. Abuja, P.M., Ascorbate prevents prooxidant effects of urate in oxidation of human low density lipoprotein. FEBS Lett, 1999. 446(2-3): p. 305-8.
24. Nishioka, K. and M. Iwatani, [Hyperuricemia and atherosclerosis]. Nippon Rinsho, 1993. 51(8): p. 2177-81.
- 50 -
25. Coutinho Tde, A., et al., Associations of serum uric acid with markers of inflammation, metabolic syndrome, and subclinical coronary atherosclerosis. Am J Hypertens, 2007. 20(1): p. 83-9.
26. Culleton, B.F., et al., Serum uric acid and risk for cardiovascular disease and death: the Framingham Heart Study. Ann Intern Med, 1999. 131(1): p. 7-13.
27. Fang, J. and M.H. Alderman, Serum uric acid and cardiovascular mortality the NHANES I epidemiologic follow-up study, 1971-1992. National Health and Nutrition Examination Survey. Jama, 2000. 283(18): p. 2404-10.
28. Brand, F.N., et al., Hyperuricemia as a risk factor of coronary heart disease: The Framingham Study. Am J Epidemiol, 1985. 121(1): p. 11-8.
29. Lee, J., et al., Uric acid and coronary heart disease risk: evidence for a role of uric acid in the obesity-insulin resistance syndrome. The Normative Aging Study. Am J Epidemiol, 1995. 142(3): p. 288-94.
30. Torun, M., et al., Serum uric acid levels in cardiovascular diseases. J Clin Pharm Ther, 1998. 23(1): p. 25-9.
31. Zavaroni, I., et al., Changes in insulin and lipid metabolism in males with asymptomatic hyperuricaemia. J Intern Med, 1993. 234(1): p. 25-30.
32. Lakka, H.M., et al., The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. Jama, 2002. 288(21): p. 2709-16.
33. McNeill, A.M., et al., Prevalence of coronary heart disease and carotid arterial thickening in patients with the metabolic syndrome (The ARIC Study). Am J Cardiol, 2004. 94(10): p. 1249-54.
34. Touboul, P.J., et al., Carotid intima-media thickness, plaques, and Framingham risk score as independent determinants of stroke risk. Stroke, 2005. 36(8): p. 1741-5.
35. Poredos, P., Intima-media thickness: indicator of cardiovascular risk and measure of the extent of atherosclerosis. Vasc Med, 2004. 9(1): p. 46-54.
36. Sonoda, M., et al., Common carotid intima-media thickness is correlated with myocardial flow reserve in patients with coronary artery disease: a useful non-invasive indicator of coronary atherosclerosis. Int J Cardiol, 2004. 93(2-3): p. 131-6.
- 51 -
37. Mattace-Raso, F., et al., Intima-media thickness of the common carotid arteries is related to coronary atherosclerosis and left ventricular hypertrophy in older adults. Angiology, 2002. 53(5): p. 569-74.
38. Touboul, P.J., et al., Carotid artery intima media thickness, plaque and Framingham cardiovascular score in Asia, Africa/Middle East and Latin America: the PARC-AALA study. Int J Cardiovasc Imaging, 2007. 23(5): p. 557-67.
39. Zureik, M., et al., Carotid plaques, but not common carotid intima-media thickness, are independently associated with aortic stiffness. J Hypertens, 2002. 20(1): p. 85-93.
40. Zanchetti, A., Prevalence of carotid atherosclerosis in hypertension: preliminary baseline data from the European Lacidipine Study on Atheroscelerosis (ELSA). Blood Press Suppl, 1996. 4: p. 30-5.
41. Handa, N., et al., Ischemic stroke events and carotid atherosclerosis. Results of the Osaka Follow-up Study for Ultrasonographic Assessment of Carotid Atherosclerosis (the OSACA Study). Stroke, 1995. 26(10): p. 1781-6.
42. Homma, S., et al., Carotid plaque and intima-media thickness assessed by b-mode ultrasonography in subjects ranging from young adults to centenarians. Stroke, 2001. 32(4): p. 830-5.
43. Kogure, D., T. Iwamoto, and M. Takasaki, [Aging and ultrasonographic findings of carotid atherosclerosis]. Nippon Ronen Igakkai Zasshi, 1997. 34(7): p. 560-8.
44. Schretlen, D.J., et al., Serum uric acid and brain ischemia in normal elderly adults. Neurology, 2007. 69(14): p. 1418-23.
45. Lehto, S., et al., Serum uric acid is a strong predictor of stroke in patients with non-insulin-dependent diabetes mellitus. Stroke, 1998. 29(3): p. 635-9.
46. Evers, S., et al., Features, symptoms, and neurophysiological findings in stroke associated with hyperhomocysteinemia. Arch Neurol, 1997. 54(10): p. 1276-82.
47. Weir, C.J., et al., Serum urate as an independent predictor of poor outcome and future vascular events after acute stroke. Stroke, 2003. 34(8): p. 1951-6.
48. Gur, M., et al., Relation of serum uric acid levels with the presence and severity of angiographic coronary artery disease. Angiology, 2008. 59(2): p. 166-71.
- 52 -
49. Jelic-Ivanovic, Z., et al., Independent association of high serum uric acid concentration with angiographically defined coronary artery disease. Tohoku J Exp Med, 2007. 211(4): p. 369-77.
50. Liu, M.L., et al., Association between carotid intima-media thickness and low-density lipoprotein size and susceptibility of low-density lipoprotein to oxidation in asymptomatic members of familial combined hyperlipidemia families. Stroke, 2002. 33(5): p. 1255-60.
51. Wagenknecht, L.E., et al., Duration of diabetes and carotid wall thickness. The Insulin Resistance Atherosclerosis Study (IRAS). Stroke, 1997. 28(5): p. 999-1005.
52. Ferrara, L.A., et al., Carotid diameter and blood flow velocities in cerebral circulation in hypertensive patients. Stroke, 1995. 26(3): p. 418-21.
53. Psaty, B.M., et al., Association between levels of blood pressure and measures of subclinical disease multi-ethnic study of atherosclerosis. Am J Hypertens, 2006. 19(11): p. 1110-7.
54. Lemne, C., T. Jogestrand, and U. de Faire, Carotid intima-media thickness and plaque in borderline hypertension. Stroke, 1995. 26(1): p. 34-9.
55. Tavil, Y., et al., Uric acid level and its association with carotid intima-media thickness in patients with hypertension. Atherosclerosis, 2008. 197(1): p. 159-63.
56. Ishizaka, N., et al., Association between serum uric acid, metabolic syndrome, and carotid atherosclerosis in Japanese individuals. Arterioscler Thromb Vasc Biol, 2005. 25(5): p. 1038-44.
57. Iribarren, C., et al., Correlates of uric acid and its association with asymptomatic carotid atherosclerosis: the ARIC Study. Atherosclerosis Risk in Communities. Ann Epidemiol, 1996. 6(4): p. 331-40.
58. Montalcini, T., et al., Relation between serum uric acid and carotid intima-media thickness in healthy postmenopausal women. Intern Emerg Med, 2007. 2(1): p. 19-23.
59. Wingrove, C.S., C. Walton, and J.C. Stevenson, The effect of menopause on serum uric acid levels in non-obese healthy women. Metabolism, 1998. 47(4): p. 435-8.
60. Cikim, A.S., et al., Associations among sex hormone binding globulin concentrations and characteristics of the metabolic syndrome in obese women. Diabetes Nutr Metab, 2004. 17(5): p. 290-5.
61. Sumino, H., et al., Reduction of serum uric acid by hormone replacement therapy in postmenopausal women with hyperuricaemia. Lancet, 1999. 354(9179): p. 650.
62. Conen, D., et al., Prevalence of hyperuricemia and relation of serum uric acid with cardiovascular risk factors in a developing country. BMC Public Health, 2004. 4: p. 9.
63. Lee, T.K., et al., Impact of alcohol consumption and cigarette smoking on stroke among the elderly in Taiwan. Stroke, 1995. 26(5): p. 790-4.
64. Lin, Y., et al., Alcohol consumption and mortality among middle-aged and elderly Japanese men and women. Ann Epidemiol, 2005. 15(8): p. 590-7.
65. Kalme, T., et al., Sex hormone-binding globulin and insulin-like growth factor-binding protein-1 as indicators of metabolic syndrome, cardiovascular risk, and mortality in elderly men. J Clin Endocrinol Metab, 2005. 90(3): p. 1550-6.
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