Antonietta Gigante, Rosa Cascone, Chiara Pellicano, Francesco Iannazzo, Francesca Romana Gadaleta, Edoardo Rosato, Rosario Cianci
{"title":"在动脉粥样硬化性肾动脉狭窄患者中，血清尿酸和血清肌酐比值作为自主神经功能障碍和左心室质量指数可能标志的作用。","authors":"Antonietta Gigante, Rosa Cascone, Chiara Pellicano, Francesco Iannazzo, Francesca Romana Gadaleta, Edoardo Rosato, Rosario Cianci","doi":"10.3390/jcdd12060202","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Serum uric acid and serum creatinine ratio (SUA/sCr) is strongly linked to increased cardiovascular risk. Atherosclerotic renal artery stenosis (ARAS) is a secondary cause of hypertension and is associated with ischemic nephropathy, congestive heart failure, accelerated cardiovascular disease, and autonomic dysfunction. The aim of this study was to investigate whether SUA levels and SUA/sCr could represent markers of autonomic dysfunction and increased left ventricular mass index (LVMI) in patients with ARAS.</p><p><strong>Methods: </strong>Patients diagnosed with ARAS were enrolled in the study. All patients underwent clinical evaluation, biochemical analysis, 24 h electrocardiogram (ECG), and Renal Doppler Ultrasound with renal resistive index parameters. Heart rate variability for global autonomic dysfunction was assessed through the analysis of a 24 h ECG to detect the standard deviation of normal-to-normal RR intervals (SDNN). Echocardiographic measurement of LVMI was performed.</p><p><strong>Results: </strong>A total of 27 patients (F = 16 (59%), median age 67 years (IQR 60-77)) diagnosed with ARAS were enrolled in the study. We found a statistically significant negative linear correlation between SUA/sCr and SDNN (r = -0.519, <i>p</i> < 0.01). We found a statistically significant positive linear correlation between SUA/sCr and LVMI (r = 0.413, <i>p</i> < 0.05). Median SDNN was significantly lower in patients with SUA ≥ 5.6 mg/dL than in patients with SUA < 5.6 mg/dL (94.2 (IQR 86.8-108.1) vs. 112.8 (IQR 108.9-114.7), <i>p</i> < 0.01). Median LVMI was significantly higher in patients with SUA ≥ 5.6 mg/dL compared to patients with SUA < 5.6 mg/dL (133 g/m<sup>2</sup> (IQR 120-149) vs. 111 g/m<sup>2</sup> (IQR 99-129), <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>In patients with ARAS, SUA/sCr is associated with autonomic dysfunction and LVMI in ARAS patients. The ratio and related cut-off value of SUA/sCr could represent a useful biomarker to evaluate cardiovascular risk in ARAS patients.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 6","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12194173/pdf/","citationCount":"0","resultStr":"{\"title\":\"The Role of Serum Uric Acid and Serum Creatinine Ratio as Possible Markers of Autonomic Dysfunction and Left Ventricular Mass Index in Atherosclerotic Renal Artery Stenosis.\",\"authors\":\"Antonietta Gigante, Rosa Cascone, Chiara Pellicano, Francesco Iannazzo, Francesca Romana Gadaleta, Edoardo Rosato, Rosario Cianci\",\"doi\":\"10.3390/jcdd12060202\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Serum uric acid and serum creatinine ratio (SUA/sCr) is strongly linked to increased cardiovascular risk. Atherosclerotic renal artery stenosis (ARAS) is a secondary cause of hypertension and is associated with ischemic nephropathy, congestive heart failure, accelerated cardiovascular disease, and autonomic dysfunction. The aim of this study was to investigate whether SUA levels and SUA/sCr could represent markers of autonomic dysfunction and increased left ventricular mass index (LVMI) in patients with ARAS.</p><p><strong>Methods: </strong>Patients diagnosed with ARAS were enrolled in the study. All patients underwent clinical evaluation, biochemical analysis, 24 h electrocardiogram (ECG), and Renal Doppler Ultrasound with renal resistive index parameters. Heart rate variability for global autonomic dysfunction was assessed through the analysis of a 24 h ECG to detect the standard deviation of normal-to-normal RR intervals (SDNN). Echocardiographic measurement of LVMI was performed.</p><p><strong>Results: </strong>A total of 27 patients (F = 16 (59%), median age 67 years (IQR 60-77)) diagnosed with ARAS were enrolled in the study. We found a statistically significant negative linear correlation between SUA/sCr and SDNN (r = -0.519, <i>p</i> < 0.01). We found a statistically significant positive linear correlation between SUA/sCr and LVMI (r = 0.413, <i>p</i> < 0.05). Median SDNN was significantly lower in patients with SUA ≥ 5.6 mg/dL than in patients with SUA < 5.6 mg/dL (94.2 (IQR 86.8-108.1) vs. 112.8 (IQR 108.9-114.7), <i>p</i> < 0.01). Median LVMI was significantly higher in patients with SUA ≥ 5.6 mg/dL compared to patients with SUA < 5.6 mg/dL (133 g/m<sup>2</sup> (IQR 120-149) vs. 111 g/m<sup>2</sup> (IQR 99-129), <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>In patients with ARAS, SUA/sCr is associated with autonomic dysfunction and LVMI in ARAS patients. The ratio and related cut-off value of SUA/sCr could represent a useful biomarker to evaluate cardiovascular risk in ARAS patients.</p>\",\"PeriodicalId\":15197,\"journal\":{\"name\":\"Journal of Cardiovascular Development and Disease\",\"volume\":\"12 6\",\"pages\":\"\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-05-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12194173/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Cardiovascular Development and Disease\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3390/jcdd12060202\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cardiovascular Development and Disease","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3390/jcdd12060202","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
背景：血清尿酸和血清肌酐比值（SUA/sCr）与心血管风险增加密切相关。动脉粥样硬化性肾动脉狭窄（ARAS）是高血压的继发原因，与缺血性肾病、充血性心力衰竭、心血管疾病加速和自主神经功能障碍有关。本研究的目的是探讨SUA水平和SUA/sCr是否可以作为ARAS患者自主神经功能障碍和左心室质量指数（LVMI）升高的标志。方法：将诊断为ARAS的患者纳入研究。所有患者均行临床评价、生化分析、24 h心电图、肾多普勒超声检查肾阻力指数参数。通过分析24小时心电图来评估全局自主神经功能障碍的心率变异性，以检测正常到正常RR间隔（SDNN）的标准偏差。超声心动图测量LVMI。结果：共有27例确诊为ARAS的患者(F = 16（59%)，中位年龄67岁（IQR 60-77））纳入研究。我们发现SUA/sCr与SDNN之间有统计学意义的负线性相关（r = -0.519, p < 0.01）。我们发现SUA/sCr与LVMI呈正线性相关（r = 0.413, p < 0.05）。SUA≥5.6 mg/dL患者的中位SDNN显著低于SUA < 5.6 mg/dL患者(94.2 （IQR 86.8-108.1) vs 112.8 (IQR 108.9-114.7), p < 0.01）。SUA≥5.6 mg/dL的患者LVMI中位数显著高于SUA < 5.6 mg/dL的患者(133 g/m2 （IQR 120-149) vs 111 g/m2 (IQR 99-129), p < 0.05）。结论：在ARAS患者中，SUA/sCr与ARAS患者自主神经功能障碍和LVMI相关。SUA/sCr比值及相关临界值可作为评估ARAS患者心血管风险的有用生物标志物。
The Role of Serum Uric Acid and Serum Creatinine Ratio as Possible Markers of Autonomic Dysfunction and Left Ventricular Mass Index in Atherosclerotic Renal Artery Stenosis.
Background: Serum uric acid and serum creatinine ratio (SUA/sCr) is strongly linked to increased cardiovascular risk. Atherosclerotic renal artery stenosis (ARAS) is a secondary cause of hypertension and is associated with ischemic nephropathy, congestive heart failure, accelerated cardiovascular disease, and autonomic dysfunction. The aim of this study was to investigate whether SUA levels and SUA/sCr could represent markers of autonomic dysfunction and increased left ventricular mass index (LVMI) in patients with ARAS.
Methods: Patients diagnosed with ARAS were enrolled in the study. All patients underwent clinical evaluation, biochemical analysis, 24 h electrocardiogram (ECG), and Renal Doppler Ultrasound with renal resistive index parameters. Heart rate variability for global autonomic dysfunction was assessed through the analysis of a 24 h ECG to detect the standard deviation of normal-to-normal RR intervals (SDNN). Echocardiographic measurement of LVMI was performed.
Results: A total of 27 patients (F = 16 (59%), median age 67 years (IQR 60-77)) diagnosed with ARAS were enrolled in the study. We found a statistically significant negative linear correlation between SUA/sCr and SDNN (r = -0.519, p < 0.01). We found a statistically significant positive linear correlation between SUA/sCr and LVMI (r = 0.413, p < 0.05). Median SDNN was significantly lower in patients with SUA ≥ 5.6 mg/dL than in patients with SUA < 5.6 mg/dL (94.2 (IQR 86.8-108.1) vs. 112.8 (IQR 108.9-114.7), p < 0.01). Median LVMI was significantly higher in patients with SUA ≥ 5.6 mg/dL compared to patients with SUA < 5.6 mg/dL (133 g/m2 (IQR 120-149) vs. 111 g/m2 (IQR 99-129), p < 0.05).
Conclusion: In patients with ARAS, SUA/sCr is associated with autonomic dysfunction and LVMI in ARAS patients. The ratio and related cut-off value of SUA/sCr could represent a useful biomarker to evaluate cardiovascular risk in ARAS patients.
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