Shimon Izhakian, Alon Gorenshtein, Haya Engelstein, Lev Freidkin, Dror Rosengarten, Ofir Eldar, Mordechai R. Kramer
{"title":"血清尿酸水平在排除重症慢性肺病肺动脉高压中的作用:来自一家三级医疗中心的启示","authors":"Shimon Izhakian, Alon Gorenshtein, Haya Engelstein, Lev Freidkin, Dror Rosengarten, Ofir Eldar, Mordechai R. Kramer","doi":"10.1007/s10238-024-01488-9","DOIUrl":null,"url":null,"abstract":"<p>Hyperuricemia is a known predictor of World Health Organization (WHO) Group 1 pulmonary hypertension (PH) (pulmonary arterial hypertension), but its role in excluding PH secondary to chronic lung diseases (WHO Group 3) remains unclear. We retrospectively analyzed data from 323 patients with severe chronic pulmonary diseases who underwent evaluation for lung transplantation at a tertiary medical center between June 2017 and February 2023. We examined the association between hyperuricemia (serum uric acid > 6 mg/dL or > 0.357 mmol/L) and PH [mean pulmonary arterial pressure (MPAP) > 20 mmHg]. Compared to the normouricemia group (n = 211), hyperuricemic patients (n = 112) were more likely to be younger (<i>P</i> = 0.02), male (<i>P</i> < 0.001), and present with PH (<i>P</i> = 0.001) and severe PH (MPAP > 35 mmHg; <i>P</i> < 0.001). These patients also had a higher body mass index (<i>P</i> = 0.004), plasma N-terminal pro-B-type natriuretic peptide (<i>P</i> < 0.001), serum creatinine (<i>P</i> < 0.001), and C-reactive protein levels (<i>P</i> = 0.03). Significant associations with PH included higher body mass index (<i>P</i> = 0.005), uric acid levels (P < 0.001), total lung capacity (<i>P</i> = 0.02), and residual volume (<i>P</i> = 0.01); shorter 6-min walk test distance (<i>P</i> = 0.005); and lower forced expiratory volume in one second (<i>P</i> = 0.006) and diffusing capacity for carbon monoxide (<i>P</i> < 0.001). Multivariate analysis showed elevated uric acid levels remained significantly associated with PH (OR 1.29, 95% CI 1.05–1.58, <i>P</i> = 0.01). In conclusion, normal serum uric acid levels serve as a significant predictor for excluding pulmonary hypertension in patients with severe chronic lung diseases.</p>","PeriodicalId":10337,"journal":{"name":"Clinical and Experimental Medicine","volume":"198 1","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Utility of serum uric acid levels in excluding pulmonary hypertension in severe chronic lung disease: insights from a tertiary care center\",\"authors\":\"Shimon Izhakian, Alon Gorenshtein, Haya Engelstein, Lev Freidkin, Dror Rosengarten, Ofir Eldar, Mordechai R. Kramer\",\"doi\":\"10.1007/s10238-024-01488-9\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>Hyperuricemia is a known predictor of World Health Organization (WHO) Group 1 pulmonary hypertension (PH) (pulmonary arterial hypertension), but its role in excluding PH secondary to chronic lung diseases (WHO Group 3) remains unclear. We retrospectively analyzed data from 323 patients with severe chronic pulmonary diseases who underwent evaluation for lung transplantation at a tertiary medical center between June 2017 and February 2023. We examined the association between hyperuricemia (serum uric acid > 6 mg/dL or > 0.357 mmol/L) and PH [mean pulmonary arterial pressure (MPAP) > 20 mmHg]. Compared to the normouricemia group (n = 211), hyperuricemic patients (n = 112) were more likely to be younger (<i>P</i> = 0.02), male (<i>P</i> < 0.001), and present with PH (<i>P</i> = 0.001) and severe PH (MPAP > 35 mmHg; <i>P</i> < 0.001). These patients also had a higher body mass index (<i>P</i> = 0.004), plasma N-terminal pro-B-type natriuretic peptide (<i>P</i> < 0.001), serum creatinine (<i>P</i> < 0.001), and C-reactive protein levels (<i>P</i> = 0.03). Significant associations with PH included higher body mass index (<i>P</i> = 0.005), uric acid levels (P < 0.001), total lung capacity (<i>P</i> = 0.02), and residual volume (<i>P</i> = 0.01); shorter 6-min walk test distance (<i>P</i> = 0.005); and lower forced expiratory volume in one second (<i>P</i> = 0.006) and diffusing capacity for carbon monoxide (<i>P</i> < 0.001). Multivariate analysis showed elevated uric acid levels remained significantly associated with PH (OR 1.29, 95% CI 1.05–1.58, <i>P</i> = 0.01). In conclusion, normal serum uric acid levels serve as a significant predictor for excluding pulmonary hypertension in patients with severe chronic lung diseases.</p>\",\"PeriodicalId\":10337,\"journal\":{\"name\":\"Clinical and Experimental Medicine\",\"volume\":\"198 1\",\"pages\":\"\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2024-09-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical and Experimental Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10238-024-01488-9\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, RESEARCH & EXPERIMENTAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical and Experimental Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10238-024-01488-9","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
Utility of serum uric acid levels in excluding pulmonary hypertension in severe chronic lung disease: insights from a tertiary care center
Hyperuricemia is a known predictor of World Health Organization (WHO) Group 1 pulmonary hypertension (PH) (pulmonary arterial hypertension), but its role in excluding PH secondary to chronic lung diseases (WHO Group 3) remains unclear. We retrospectively analyzed data from 323 patients with severe chronic pulmonary diseases who underwent evaluation for lung transplantation at a tertiary medical center between June 2017 and February 2023. We examined the association between hyperuricemia (serum uric acid > 6 mg/dL or > 0.357 mmol/L) and PH [mean pulmonary arterial pressure (MPAP) > 20 mmHg]. Compared to the normouricemia group (n = 211), hyperuricemic patients (n = 112) were more likely to be younger (P = 0.02), male (P < 0.001), and present with PH (P = 0.001) and severe PH (MPAP > 35 mmHg; P < 0.001). These patients also had a higher body mass index (P = 0.004), plasma N-terminal pro-B-type natriuretic peptide (P < 0.001), serum creatinine (P < 0.001), and C-reactive protein levels (P = 0.03). Significant associations with PH included higher body mass index (P = 0.005), uric acid levels (P < 0.001), total lung capacity (P = 0.02), and residual volume (P = 0.01); shorter 6-min walk test distance (P = 0.005); and lower forced expiratory volume in one second (P = 0.006) and diffusing capacity for carbon monoxide (P < 0.001). Multivariate analysis showed elevated uric acid levels remained significantly associated with PH (OR 1.29, 95% CI 1.05–1.58, P = 0.01). In conclusion, normal serum uric acid levels serve as a significant predictor for excluding pulmonary hypertension in patients with severe chronic lung diseases.
期刊介绍:
Clinical and Experimental Medicine (CEM) is a multidisciplinary journal that aims to be a forum of scientific excellence and information exchange in relation to the basic and clinical features of the following fields: hematology, onco-hematology, oncology, virology, immunology, and rheumatology. The journal publishes reviews and editorials, experimental and preclinical studies, translational research, prospectively designed clinical trials, and epidemiological studies. Papers containing new clinical or experimental data that are likely to contribute to changes in clinical practice or the way in which a disease is thought about will be given priority due to their immediate importance. Case reports will be accepted on an exceptional basis only, and their submission is discouraged. The major criteria for publication are clarity, scientific soundness, and advances in knowledge. In compliance with the overwhelmingly prevailing request by the international scientific community, and with respect for eco-compatibility issues, CEM is now published exclusively online.