Effect of Uric Acid and Hypersensitive C-reactive Protein on Cardiovascular Disease in Patients with Chronic Kidney Disease
Journal: Journal of Clinical Medicine Research DOI: 10.32629/jcmr.v6i1.3675
Abstract
Objectives: To explore the effects of uric acid(UA) and hypersensitive C-reactive(hs-CRP) protein on cardiovascular disease in chronic kidney disease. Methods: Using the prospective cohort study method, patients with chronic kidney disease who participated in Kailuan Group's health examination for the first time from 2006 to 2012 were selected as the observation objects, and the new cardiovascular disease was taken as the endpoint event, and the uric acid and hs-CRP levels were grouped, which were as follows: low UA/low hs-CRP group, the high UA/low hs-CRP, low UA/high hs-CRP and high UA/high hs-CRP groups. Multivariate Cox proportional hazards regression was used to analyze the effects of different groups on cardiovascular disease. Result: Cox regression analysis showed that after adjusting for confounding factors such as age and sex, compared with low uric acid and low hs-CRP group, the cardiovascular disease HR (95%CI) of the high uric acid group alone, high hs-CRP group alone, and high uric acid high hs-CRP group were 1.27(1.10-1.46), 1.25(1.14-1.38), and 1.34(1.11-1.61), respectively, all P < 0.01. The combined effect between UA and hs-CRP was associated with cardiovascular disease risk (P for interaction < 0.05). Conclusions: Uric acid and hs-CRP had a combined effect on increased risk of CVD in patients with CKD, and the association was independent of patients' baseline eGFR levels.
Keywords
chronic kidney disease population; cardiovascular disease; combined exposure; cohort study
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[5] Chinese Consensus Expert Group on Diagnosis and Treatment of chronic kidney disease patients with hyperuricemia. Expert consensus on diagnosis and treatment of hyperuricemia in Chinese patients with chronic kidney disease [J]. Chinese Journal of Nephrology, 2017, 33(6): 463-469. (in Chinese)
[6]Li Z, Liu Q, Mao H, et al. Gender difference in the association of hyperuricemia with chronic kidney disease in southern China. Kidney Blood Press Res. 2012;36(1):98-106.
[7]Luo Q, Xia X, Li B, et al. Serum uric acid and cardiovascular mortality in chronic kidney disease: a meta-analysis. BMC Nephrol. 2019 Jan 14;20(1):18.
[8]Li N, Wu S, Shu R, et al. The combination of high uric acid and high C-reactive protein increased the risk of cardiovascular disease: A 15-year prospective cohort study. Nutr Metab Cardiovasc Dis. 2024 Jun;34(6):1508-1517.
[9]Tsuruya K, Yoshida H, Nagata M, et al. Impact of the Triglycerides to High-Density Lipoprotein Cholesterol Ratio on the Incidence and Progression of CKD: A Longitudinal Study in a Large Japanese Population. Am J Kidney Dis. 2015 Dec;66(6):972-83.
[10]Levey AS, Stevens LA, Schmid CH, et al. A new equation to estimate glomerular filtration rate [J]. Ann Intern Med,2009,150(9) : 604-612
[11] Chinese Hypertension Guidelines Revision Committee, Hypertension Alliance (China), Chinese Society of Cardiology, et al. Chinese Guidelines for Prevention and Treatment of hypertension (2018 Revision)[J]. Chinese Journal of Cardiology,2019,24 (1): 24-56. (in Chinese)
[12] Chinese Society of Diabetics. Chinese Guidelines for Prevention and Treatment of Type 2 diabetes (2017 edition)[J]. Chinese Journal of Practical Internal Medicine,2018,38(4):292-344. (in Chinese)
[13] Expert group of Clinical Quality Control Center of Shanghai Department of Nephrology. Guidelines for early screening, diagnosis and Prevention of chronic kidney disease (2022 edition) [J]. Chinese Journal of Nephrology, 2022, 38(5): 453-464. (in Chinese)
[14] Multidisciplinary consensus expert Group on the Diagnosis and treatment of hyperuricemia related diseases. Multidisciplinary expert consensus on diagnosis and treatment of hyperuricemia related diseases in China [J]. Chinese Journal of Internal Medicine,2017,56(3):235-248. (in Chinese
[15]Stroke--1989. Recommendations on stroke prevention, diagnosis, and therapy. Report of the WHO Task Force on Stroke and other Cerebrovascular Disorders. Stroke. 1989 Oct;20(10):1407-31.
[16]Holme I, Aastveit AH, Hammar N, et al. Uric acid and risk of myocardial infarction, stroke and congestive heart failure in 417,734 men and women in the Apolipoprotein MOrtality RISk study (AMORIS). J Intern Med. 2009 Dec;266(6):558-70.
[17]Mazza A, Pessina AC, Pavei A, et al. Predictors of stroke mortality in elderly people from the general population. The CArdiovascular STudy in the ELderly. Eur J Epidemiol. 2001;17(12):1097-104.
[18]Cesari M, Penninx BW, Newman AB, et al. Inflammatory markers and onset of cardiovascular events: results from the Health ABC study. Circulation. 2003 Nov 11;108(19):2317-22.
[19]Dugani SB, Moorthy MV, Li C, et al. Association of Lipid, Inflammatory, and Metabolic Biomarkers With Age at Onset for Incident Coronary Heart Disease in Women. JAMA Cardiol. 2021 Apr 1;6(4):437-447.
[20]Antón FM, García Puig J, Ramos T, et al. Sex differences in uric acid metabolism in adults: evidence for a lack of influence of estradiol-17 beta (E2) on the renal handling of urate. Metabolism. 1986 Apr;35(4):343-8.
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