The effects of cardiometabolic factors on the association between serum uric acid and risk of all-cause mortality in adults with congestive heart failure.

IF 2.6 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Tao Liu, Jia Song, Ronghua Zuo, Lifang Sun, Zhijian Zhu, Bing Wang, Zhigang Lu, Yesheng Pan
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引用次数: 0

Abstract

Background: Serum uric acid (SUA) has been shown to increase all-cause mortality from cardiovascular disease. However, limited studies have examined the mediating effect of dyslipidemia, hyperglycemia, or hypertension on the association between SUA and all-cause mortality in patients with congestive heart failure (CHF).

Methods: Participants in the present investigation were 620 US adults with CHF from the NHANES database (1999-2014). The relationship between SUA and all-cause mortality was evaluated utilizing multivariable Cox proportional hazards models. Additionally, the nonlinearity between SUA and mortality was investigated utilizing Restricted Cubic Splines (RCS) and 2-piecewise Cox proportional hazards models. Finally, the mediating role of cardiometabolic factors on the relationship between SUA and all-cause mortality was investigated utilizing the mediation analysis.

Results: During a mean follow-up of 7.6 years, 391 (63.1%) all-cause deaths occurred. Furthermore, we found a U-shaped association between SUA and all-cause mortality. The inflection point for the RCS curve was found at a SUA level of 363 umol/L. The hazard ratios (95% confidence intervals) for all-cause mortality were 0.998 (0.995-1.000) and 1.003 (1.002-1.005) to the left and right of the inflection point, respectively. This U-shaped association was also observed in both subgroups of sex and age. Moreover, the effect of SUA on all-cause mortality was not mediated by hypertension, hyperglycemia, or dyslipidemia (all P-values>0.05).

Conclusion: The association between SUA level and all-cause mortality followed a U-shaped curve, and this association was not mediated by hypertension, hyperglycemia, or dyslipidemia.

心脏代谢因素对充血性心力衰竭成人血清尿酸与全因死亡风险之间关系的影响。
背景:血清尿酸(SUA)已被证明可增加心血管疾病的全因死亡率。然而,有限的研究已经检查了血脂异常、高血糖或高血压在充血性心力衰竭(CHF)患者的SUA和全因死亡率之间的关联中的中介作用。方法:本次调查的参与者是来自NHANES数据库(1999-2014)的620名美国成年CHF患者。利用多变量Cox比例风险模型评估SUA与全因死亡率之间的关系。此外,利用限制三次样条(RCS)和2分段Cox比例风险模型研究了SUA与死亡率之间的非线性关系。最后,利用中介分析探讨心脏代谢因素在SUA与全因死亡率关系中的中介作用。结果:在平均7.6年的随访期间,发生了391例(63.1%)全因死亡。此外,我们发现SUA与全因死亡率之间呈u型关系。RCS曲线的拐点出现在SUA水平为363 umol/L时。拐点左右的全因死亡率风险比(95%置信区间)分别为0.998(0.995-1.000)和1.003(1.002-1.005)。在性别和年龄两个亚组中也观察到这种u形关联。此外,SUA对全因死亡率的影响不是由高血压、高血糖或血脂异常介导的(p值均>0.05)。结论:SUA水平与全因死亡率呈u型曲线关系,且与高血压、高血糖或血脂异常无关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Postgraduate Medicine
Postgraduate Medicine 医学-医学:内科
CiteScore
6.10
自引率
2.40%
发文量
110
审稿时长
6-12 weeks
期刊介绍: Postgraduate Medicine is a rapid peer-reviewed medical journal published for physicians. Tracing its roots back to 1916,  Postgraduate Medicine  was established by Charles Mayo, MD, as a peer-to-peer method of communicating the latest research to aid physicians when making treatment decisions, and it maintains that aim to this day. In addition to its core subscriber base, Postgraduate Medicine is distributed to hundreds of US-based physicians within internal medicine and family practice.
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